Association between statin use and risk for keratinocyte carcinoma in the veterans affairs topical tretinoin chemoprevention trial.

Abstract

BACKGROUND:

Recent evidence suggests that statins may prevent cancer.

OBJECTIVE:

To quantify the association between statin use and the occurrence of keratinocyte carcinoma in high-risk veterans.

DESIGN:

Cohort study.

SETTING:

6 Veterans Affairs medical centers.

PARTICIPANTS:

1037 participants of the Veterans Affairs Topical Tretinoin Chemoprevention Trial, a randomized, multicenter, double-blind, vehicle-controlled trial of topical tretinoin, 0.1%, for prevention of keratinocyte carcinoma conducted from November 1998 to November 2004.

MEASUREMENTS:

Time to first occurrence of keratinocyte carcinoma on the face or ears. Participants using a statin at randomization, according to the Veterans Affairs Pharmacy Benefits Management database, were considered exposed. Study dermatologists conducted physical examinations at baseline and every 6 months during follow-up. The association between statin use at randomization and the outcome was evaluated by using propensity score matching (n = 608) and Cox proportional hazards regression (n = 1037).

RESULTS:

Among the 1037 participants, 37% used a statin at randomization (n = 397) for a median duration of at least 900 days over a median follow-up of 3.5 years. In the propensity score-matched analysis, statin use at randomization was not associated with keratinocyte carcinoma (rate ratio, 0.92 [95% CI, 0.73 to 1.16]), a finding that was consistent with the estimates derived from the Cox proportional hazards regression (rate ratio, 0.84 [CI, 0.70 to 1.02]).

LIMITATIONS:

The extent of residual confounding is unknown, and the confidence bounds around the measures of association were wide. These data may not be generalizable to lower-risk populations.

CONCLUSION:

These data show no conclusive or consistent relationship between long-term statin use and risk for keratinocyte carcinoma.

• Authors: David D Dore, Kate L Lapane, Amal N Trivedi, Vincent Mor, Martin A Weinstock
• Journal: Annals of internal medicine (Ann Intern Med) Vol. 150 Issue 1 Pg. 9-18 (Jan 06 2009) ISSN: 1539-3704 [Electronic] United States
• PMID: 19124815 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S., Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Antineoplastic Agents
• Tretinoin

Topics

• Administration, Topical
• Aged
• Aged, 80 and over
• Antineoplastic Agents (therapeutic use)
• Carcinoma, Basal Cell (epidemiology, prevention & control)
• Carcinoma, Squamous Cell (epidemiology, prevention & control)
• Confounding Factors, Epidemiologic
• Double-Blind Method
• Drug Administration Schedule
• Ear Neoplasms (epidemiology, prevention & control)
• Facial Neoplasms (epidemiology, prevention & control)
• Female
• Humans
• Male
• Middle Aged
• Neoplasm Recurrence, Local (epidemiology, prevention & control)
• Risk Factors
• Skin Neoplasms (epidemiology, prevention & control)
• Tretinoin (therapeutic use)