Statin use tied to lower liver cancer risk

Last Updated: 2015-03-13

By David Douglas

NEW YORK (Reuters Health) - Statin use is associated with a lower risk of liver cancer, according to an analysis of UK data.

"This finding may have particular significance for individuals at increased risk of liver cancer due to the presence of chronic liver disease or diabetes, as our study found that statins were associated with reduced risk in the presence of these factors," Dr. Katherine A. McGlynn of the National Cancer Institute in Bethesda, Maryland told Reuters Health by email.

In a paper online February 25 in the Journal of the National Cancer Institute, Dr. McGlynn and colleagues note that most studies hinting of a protective effect have been from regions of the world with high liver cancer incidence rates.

To investigate the situation in a low-cancer-risk setting the researchers examined a population-based, automated medical records database containing information on approximately 8.5% of the UK population.

In total, 1,195 people with a first-time diagnosis of primary liver cancer between 1988 and 2011 were matched with 4,640 control patients.

After adjusting for potential confounders, statin use was associated with a significantly reduced risk of liver cancer (odds ratio, 0.55), particularly for current users (OR, 0.53). The risk reduction was more pronounced in the presence of liver disease (OR, 0.32) or diabetes (OR, 0.30).

Among strengths of the study, say the researchers, was that "it was conducted in a country that has universal health care coverage, thus decreasing the chance that the results were biased because of failure to consider socioeconomic status."

Overall, they conclude, the outcomes "suggest that use of statins among persons at high risk of developing liver cancer, even in low-risk settings, may have a net cancer protective effect."

Commenting on the findings by email, Dr. Stig E. Bojesen from the University of Copenhagen in Denmark told Reuters Health that this "is by far the largest Western European study of liver cancer and statin use, and the authors mention themselves that because liver cancer is so rare among Western Europeans, there are no immediate clinical implications."

Dr. Bojesen, who has conducted research in the field, added that, "The perspective is of course to identify subgroups of the population with vastly increased a priori risk of liver cancer, and perform a randomized trial. Such a study could also circumvent the major weakness of this and all other observational studies: that the results were produced by unknown and therefore unaddressed confounding factors, e. g. patients' behaviour."

"Patients who take their prescribed statins," concluded Dr. Bojesen, "are in general more capable of taking care of other aspects of their health as well, than patients who do not take statins; the latter are also more likely to develop liver cancer. Thereby, the results from this study could be due to confounding, rather than biology, and the only way to get rid of this confounding is to perform a randomized trial, which is now much more justified than prior to (this) publication."

SOURCE: http://bit.ly/1EbuShV

J Natl Cancer Inst 2015.