November 14, 2013

Use of Statins Linked to Reduced Risk of Hepatocellular Carcinoma

Source: DGNews  |  Presented at AASLD

By Brian Hoyle

WASHINGTON, DC -- November 6, 2013 -- Statin use has been firmly linked with a decreased risk of hepatocellular carcinoma (HCC), according to results of a large, prospective study presented at the 64th Annual Meeting of the American Association for the Study of Liver Diseases (AASLD).

“These data support a potential role for statins in the chemoprevention of HCC,” stated lead author Lindsay King, MD, Massachusetts General Hospital, Boston, Massachusetts, speaking at a poster presentation here on November 5.

For their analysis, Dr. King and colleagues harnessed 2 large population-based US cohorts with over 20 years of follow-up: the Health Professionals Follow-up Study (1990 to present) and the Nurses’ Health Study (1994 to present). Their study charted 136,178 individuals (96,544 female) with no prior history of cancer. Follow-up exceeded 90%.

Regular users of statins had a multivariate hazard ratio (HR) of 0.58 (95% confidence interval [CI] 0.35 to 2 0.94, P= .03) for HCC compared with non-users, after adjusting for age, body mass index, diabetes, aspirin use, smoking status, and alcohol intake.

The inverse association of statins and HCC appeared to be similar in women (multivariate-adjusted HR = 0.77, 95% CI 0.46 to 1.30) compared with men (multivariate adjusted HR = 0.58, 95% CI 0.24 to 1.38).

Over 20 years of follow-up, there were 126 incident cases of HCC over 1,926,436 person years (py) -- 61 out of 1,031,096 py in female non-users and 15 out of 263,553 py in female statin users, and 43 out of 519,794 py in male non-users and 7 out of 111,483 py in male statin users.

Statins were used by 22,137 subjects (15,553 female) and were not used by 94,686 subjects (69,440 female).

Data were collected every 2 years on statin use, other lifestyle risk factors, and diagnoses of cancer and other chronic diseases. HCC was identified using the International Classification of Diseases-Ninth Revision (ICD9) 155 code and outcomes revealed from medical records. Cox proportional hazards models were used to estimate HRs and 95% CIs for HCC.

Baseline characteristics were similar with respect to age, body mass index, diabetes, aspirin use, smoking status, and alcohol intake.

The mechanism of the HCC chemoprevention prowess of statins remains unknown, as do the details of the risk of HCC with duration of statin use. The researchers concluded that studies are warranted that will answer these unknowns.

[Presentation title: Statins Are Associated With a Reduced Risk of Liver Cancer: Data from a Large U.S. Prospective Cohort Study. Abstract 2085]

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