Statins: could they decrease death risk in four most common cancers

Use of statins may be associated with reduced mortality and improved survival in lung, breast, prostate, and bowel cancers, according to research presented at Frontiers in CardioVascular Biology (FCVB) 2016.

The 14-year study, which included nearly 1 million patients, finds that a high cholesterol diagnosis is associated with a lower risk of death in four common cancers.

"The discovery of a link between obesity and high cholesterol as risk factors for cancer has been exciting for researchers and the public. Even trendier is the idea that if high cholesterol can cause cancer, then cholesterol-lowering interventions such as statins could reduce this risk," says lead author Dr. Paul Carter, from Aston University in Birmingham, United Kingdom.

"We previously found an association between having high cholesterol and developing breast cancer. Animal studies show that giving statins for high cholesterol can reduce the risk of breast cancer. We wanted to see if there was any effect of high cholesterol on mortality amongst cancer patients."

The four most common cancers in the U.K. - lung, breast, prostate, and bowel cancers - were investigated to determine if there was an association between high cholesterol and risk of mortality in patients with these diseases.

The study focused on patients admitted to hospitals in the U.K. between January 1, 2000, and March 31, 2013, with one of the four cancers.

The patients were recruited from Algorithm for Comorbidities, Associations, Length of stay and Mortality (ACALM) clinical database, which included data on co-existing conditions such as high cholesterol.

Mortality data was acquired from the Office for National Statistics.

The ACALM study has a total of 929,552 patients. Within this group, 7,997 had lung cancer, 5,481 had breast cancer, 4,629 had prostate cancer, and 4,570 had bowel cancer.

Diagnosis of high cholesterol improves survival rate

When factors that might influence mortality such as age, gender, and ethnicity had been adjusted, researchers learned that patients with cancer were less likely to die if they had a high cholesterol diagnosis than those patients that did not.

A diagnosis of high cholesterol indicated a 22 percent lower risk of death in patients with lung cancer, 43 percent lower risk in breast cancer, 47 percent lower risk in prostate cancer, and 30 percent lower risk in bowel cancer patients.

"Our research suggests that there's something about having a high cholesterol diagnosis that improves survival and the extent to which it did that was quite striking in the four cancers studied. Based on previous research we think there's a very strong possibility that statins are producing this effect."

Dr. Carter, Aston University in Birmingham, U.K.

Dr. Carter continues to say that they think the effect is caused by high cholesterol medications such as statins, as the association was noted amongst all four cancers. However, studies would need to be conducted in other types of cancer to confirm this speculation.

Dr. Rahul Potluri, a senior author and founder of the ACALM Study Unit, notes:

"Statins have some of the best mortality evidence amongst all cardiovascular medications and statin use in patients with a diagnosis of high cholesterol is possibly the main reason that this diagnosis appears to be protective against death in patients with lung, breast, prostate and bowel cancer."

"Other cardiovascular medications may also be protective and explain the varying levels of risk reduction in the four cancer types. For example, prostate cancer is associated with heart disease and these patients tend to take ACE inhibitors and beta-blockers."

He adds, "The results of this study strengthen the argument for a clinical trial evaluating the possible protective effect of statins and other routinely used cardiovascular medications such as aspirin, blood pressure medications, beta-blockers and ACE inhibitors in patients with cancer. Whether it is statins and/or other cardiovascular drugs in combination that have an effect on mortality remains to be seen."

Dr. Potluri concludes that although statins look to have a positive outcome, until there is a positive result in a clinical trial, patients with cancer that are at high risk or have established cardiovascular disease should only be prescribed statins as per current guidelines.