Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Sep 13;7(37):59618-59629.
doi: 10.18632/oncotarget.11162.

Statins dose-dependently exert a chemopreventive effect against lung cancer in COPD patients: a population-based cohort study

Ju-Chi Liu  1   2 , Tsung-Yeh Yang  1 , Yi-Ping Hsu  1 , Wen-Rui Hao  1 , Pai-Feng Kao  1   2 , Li-Chin Sung  1   2 , Chun-Chao Chen  1 , Szu-Yuan Wu  3   4   2   5
Affiliations

Statins dose-dependently exert a chemopreventive effect against lung cancer in COPD patients: a population-based cohort study

Ju-Chi Liu et al. Oncotarget. .

Abstract

Purpose: Chronic obstructive pulmonary disease (COPD) is associated with increased lung cancer risk. We evaluated the association of statin use with lung cancer risk in COPD patients and identified which statins possess the highest chemopreventive potential.

Results: After adjustment for age, sex, CCI, diabetes, hypertension, dyslipidemia, urbanization level, and monthly income according to propensity scores, lung cancer risk in the statin users was lower than that in the statin nonusers (adjusted hazard ratio [aHR] = 0.37). Of the individual statins, lovastatin and fluvastatin did not reduce lung cancer risk significantly. By contrast, lung cancer risk in patients using rosuvastatin, simvastatin, atorvastatin, and pravastatin was significantly lower than that in statin nonusers (aHRs = 0.41, 0.44, 0.52, and 0.58, respectively). Statins dose-dependently reduced lung cancer risk in all subgroups and the main model with additional covariates (nonstatin drug use).

Materials and methods: The study cohort comprised all patients diagnosed with COPD at health care facilities in Taiwan (n = 116,017) between January 1, 2001 and December 31, 2012. Our final study cohort comprised 43,802 COPD patients: 10,086 used statins, whereas 33,716 did not. Patients were followed up to assess lung cancer risk or protective factors. In addition, we also considered demographic characteristics, namely age, sex, comorbidities (diabetes, hypertension, dyslipidemia, and Charlson comorbidity index [CCI]), urbanization level, monthly income, and nonstatin drug use. The index date of statin use was the COPD confirmation date. To examine the dose-response relationship, we categorized statin use into four groups in each cohort: < 28, 28-90, 91-365, and > 365 cumulative defined daily doses (cDDDs). Patients receiving < 28 cDDDs were defined as nonstatin users.

Conclusions: Statins dose-dependently exert a significant chemopreventive effect against lung cancer in COPD patients. Rosuvastatin, simvastatin, and atorvastatin exhibited the highest chemopreventive potential.

Keywords: COPD; lung cancer; statins.

PubMed Disclaimer

Conflict of interest statement

CONFLICTS OF INTEREST

None.

Figures

Figure 1
Figure 1. Patient selection flowchart
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Health Promotion Administration MoHaW . Taiwan Cancer Registry report, 2011 edition. Health Promotion Administration, Ministry of Health and Welfare; 2011.
    1. Kuller LH, Ockene J, Meilahn E, Svendsen KH. Relation of forced expiratory volume in one second (FEV1) to lung cancer mortality in the Multiple Risk Factor Intervention Trial (MRFIT) Am J Epidemiol. 1990;132:265–74. - PubMed
    1. Nomura A, Stemmermann GN, Chyou PH, Marcus EB, Buist AS. Prospective study of pulmonary function and lung cancer. Am Rev Respir Dis. 1991;144:307–11. - PubMed
    1. Hole DJ, Watt GC, Davey-Smith G, Hart CL, Gillis CR, Hawthorne VM. Impaired lung function and mortality risk in men and women: findings from the Renfrew and Paisley prospective population study. BMJ. 1996;313:711–5. - PMC - PubMed
    1. Chen CI, Kuan CF, Fang YA, Liu SH, Liu JC, Wu LL, Chang CJ, Yang HC, Hwang J, Miser JS, Wu SY. Cancer risk in HBV patients with statin and metformin use: a population-based cohort study. Medicine (Baltimore) 2015;94:e462. - PMC - PubMed

Substances