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Clinical Research

Statin use and risk of prostate cancer and high-grade prostate cancer: results from the REDUCE study

Prostate Cancer and Prostatic Diseases volume 16, pages 254–259 (2013)Cite this article

Subjects

Abstract

Background:

Statins are associated with lower PSA levels. As PSA is the primary method for prostate cancer (PC) screening, this confounds any associations between statins and risk of being diagnosed with PC. Thus, we examined the association between statins and cancer and high-grade cancer in REDUCE, where biopsies were largely PSA-independent.

Methods:

Post-hoc secondary analysis of REDUCE, which was a prospective multinational randomized controlled trial of dutasteride vs placebo for 4 years among men aged 50–75 years with PSA of 2.5–10.0 ng ml−1 and a negative biopsy at baseline, and included PSA-independent biopsies mandated at 2- and 4-years. Analyses were limited to men who underwent at least one biopsy while under study (n=6729). The association between baseline statin use and risk of overall, high-grade (Gleason ⩾7) or low-grade (Gleason ⩽6) PC vs no cancer was examined using multinomial logistic regression adjusting for age, race, baseline PSA, prostate volume, rectal examination findings, body mass index (BMI), comorbidities, smoking, alcohol intake and treatment arm.

Results:

Of 6729 men who had at least one biopsy while on study, 1174 (17.5%) were taking a statin at baseline. Men taking statins were older, had lower PSA levels, higher BMI values and lower serum testosterone and dihydrotestosterone levels, though differences, were slight. Statin use was not associated with overall PC diagnosis (multivariable OR 1.05, 95% CI 0.89–1.24, P=0.54). When stratified by grade, statin use was not associated with low-grade (multivariable OR 1.03, 95% CI 0.85–1.25, P=0.75) or high-grade cancer (multivariable OR 1.11, 95% CI 0.85–1.45, P=0.46). The major limitation is the inclusion of only men with a negative baseline biopsy.

Conclusions:

Among men with a negative baseline biopsy and follow-up biopsies largely independent of PSA, statins were not associated with cancer or high-grade cancer.

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Acknowledgements

We wish to acknowledge the dedication of the patients, investigators, data and safety monitoring committee, steering committee and GSK in the initiation and conduct of the REDUCE study.

Role of the sponsor

The REDUCE study was sponsored by GlaxoSmithKline (GSK). Data were then transferred to Drs Freedland, Bañez, Moreira and Ms Gerber who formatted the data and conducted the analyses funded through an investigator-initiated grant from GSK to Dr Freedland. None of Dr Freedland’s salary was paid for by GSK. GSK had no role in analyzing these data or writing the manuscript. GSK did review the final version of the manuscript.

Author information

Authors and Affiliations

  1. Surgery Section, Durham VA Medical Center, Durham, NC, USA

    S J Freedland, L Gerber, L L Banez & D M Moreira

  2. Division of Urological Surgery, Department of Surgery, Duke Prostate Center, Duke University School of Medicine, Durham, NC, USA

    S J Freedland, L Gerber & D M Moreira

  3. Department of Pathology, Duke University School of Medicine, Durham, NC, USA

    S J Freedland

  4. Department of Urology, University of Toronto, Toronto, CA, USA

    R J Hamilton

  5. Division of Urology, Washington University School of Medicine in St Louis, St Louis, MO, USA

    G L Andriole

  6. Research Triangle Park, Durham, NC, USA

    R S Rittmaster

Authors
  1. S J Freedland
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  4. L L Banez
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Corresponding author

Correspondence to S J Freedland.

Ethics declarations

Competing interests

Dr Freedland reports receiving consulting fees from Amgen, Bayer, Mitomics, Medivation, Dendreon and Janssen and lecture fees from AstraZeneca, Amgen and Janssen. Dr Bañez reports being an investigator for AstraZeneca. Dr Andriole reports receiving consulting or advisory fees from Aeterna Zentaris, Amgen, EMD Serono, Ferring Pharmaceuticals, GenProbe, GSK, Myriad Genetics, Nema Steba, Onconome and Veridex; Equity ownership/stock from Cambridge Endo, Envisioneering Medical and Viking Medical; Lecture fees from GSK. Dr Rittmaster reports being a past employee of GSK and having equity ownership/stock from GSK. He retired from GSK after the completion of the REDUCE Study, but before analysis and submission of this manuscript and currently has no affiliation. The remaining authors declare no conflict of interest.

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Freedland, S., Hamilton, R., Gerber, L. et al. Statin use and risk of prostate cancer and high-grade prostate cancer: results from the REDUCE study. Prostate Cancer Prostatic Dis 16, 254–259 (2013). https://doi.org/10.1038/pcan.2013.10

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