ANAHEIM, CaliforniaStatins, but not other lipid-lowering drugs, are associated with reduced rates of prostate cancer, have their greatest effect on stage T3 cancers, and may act in part by altering prostate gland biology, according to research presented at the 102nd Annual Scientific Meeting of the American Urological Association. The researchers argued strongly for large-scale trials of statins for prevention of prostate cancer. Among the studies:
• Janet L. Colli, MD, and colleagues from the University of Alabama at Birmingham found that declining prostate cancer mortality rates for white males in the United States correlated with high cholesterol levels. They doubt that this is because cholesterol prevents cancer, suggesting instead that the protective effect might be due to widespread use of statins in this group (abstract 203).
• Teemu J. Murtola, MD, and colleagues from the University of Tampere, Finland, added substance to this idea with data from a screening study of 23,320 men showing that those taking statins had only half as many prostate cancers as those not taking statins (abstract 1719).
• Robert J. Hamilton, MD, and colleagues at the Durham Veterans Affairs Medical Center and Duke University found that even in normal men, statins significantly reduce PSA levels and so probably alter prostate biology (abstract 463). Dr. Hamilton urged further study of statins for prevention of prostate cancer but also raised the concern that the PSA-lowering effect might interfere with prostate cancer detection.
Dr. Colli's study used data from the National Vital Statistics System to determine the rate of prostate cancer mortality decline for the years 1993 to 2003 for each of the 48 continental states. The annual rate of prostate mortality decline for each state was then cross-correlated with rates of PSA screening, health insurance coverage, obesity, physical inactivity, diabetes, and hyperlipidemia or high cholesterol.
The analysis revealed a strong correlation in white men between declining prostate cancer mortality and PSA screening (R = -0.28, P = .05) and elevated cholesterol levels (R = -0.42, P = .002). Declining prostate cancer mortality rates for black men in the study correlated only with health insurance coverage (R = -0.43, P = .03). "Future large-scale prostate cancer prevention trials examining the effects of statin use on risk of prostate cancer and prostate cancer mortality need to be conducted," Dr. Colli concluded.
Dr. Murtola and colleagues studied all screened participants of the Finnish Prostate Cancer Screening Trial during 1996 to 2004 (23,320 men) with detailed information on cholesterol drug usage during that time period. There were three screening rounds during the study period, and each man was screened for PSA at least once. The researchers correlated these subjects' prostate cancer status with their medication use, obtained from the Social Insurance Institution of Finland database.