Statins Linked With Reduced Liver Cancer in Low-Rate Areas

Current use of statins was associated with about a 50% decreased risk for liver cancer, according to results of a study looking at data from the United Kingdom.

Current use of statins was associated with about a 50% decreased risk for liver cancer, with a reduced risk for liver cancer seen whether or not patients had risk factors such as liver disease or diabetes, according to results of a study looking at data from the United Kingdom’s Clinical Practice Research Datalink (CPRD).

“Promising evidence that statins may decrease risk of liver cancer has been reported in observational studies, many of which were conducted in Taiwan,” wrote Katherine A. McGlynn, PhD, of the division of cancer epidemiology and genetics at the National Cancer Institute, and colleagues in the Journal of the National Cancer Institute. “The results of studies from areas with low rates of liver cancer, however, have been less consistent.”

With this study, therefore, unlike studies in Taiwan, an area with a high liver cancer incidence, McGlynn and colleagues examined the relationship of statins with liver cancer in a low-rate area. They identified 1,195 people with primary liver cancer and matched them with 4,640 control patients from the CPRD. The patients with liver cancer were significantly more likely to be obese, current or ex-smokers, have an alcohol-related condition, be infected with hepatitis B or C, have chronic liver disease, have a rare metabolic disorder, or have diabetes.

Statin use was found to confer a 45% reduced risk for liver cancer among the entire study cohort (OR = 0.55; 95% CI, 0.45-0.69). Specifically, this reduced risk was seen for patients taking simvastatin (OR = 0.57; 95% CI, 0.45-0.74), atorvastatin (OR = 0.53; 95% CI, 0.38-0.75), and rosuvastatin (OR = 0.42; 95% CI, 0.19-0.97).

The researchers also examined any protective effect of statins among people with risk factors for liver cancer. Among people with chronic liver disease, statin use was found to reduce risk for liver disease by 68% (OR = 0.32; 95% CI, 0.17-0.57), with a more evident risk reduction among current users of statins.  However, an association with reduced risk for liver cancer was found for statin use even among people without chronic liver disease (OR = 0.65; 95% CI, 0.52-0.81).

In addition, a reduced risk for liver cancer was found in the presence (OR = 0.30; 95% CI, 0.21-0.42) or absence of diabetes (OR = 0.66; 95% CI, 0.51-0.85).

“A prospective study design would have permitted the more precise capture of medical conditions, but such a study would be prohibitively large and costly given that liver cancer is a rare outcome,” the researchers wrote. “To conduct a trial, it is likely that many persons in the non-intervention arm would have to be taken off a class of drugs that has been demonstrated to reduce serum cholesterol levels, thereby undoubtedly raising ethical concerns. In conclusion, the results of the current study 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.”