Evaluation of the relationship between previous statin use and thyroid cancer using Korean National Health Insurance Service-Health Screening Cohort data

Abstract

The association of thyroid cancer with statin use is controversial. This study aimed to investigate the association of previous statin use with thyroid cancer in the ≥ 40-year-old population in the Korean National Health Insurance Service-Health Screening Cohort. The 5501 patients in the thyroid cancer group were matched with the 22,004 patients in the non-thyroid cancer group for age, sex, income, and region of residence. Previous statin use during the 2 years before the diagnosis of thyroid cancer was examined. The odds ratios (ORs) with 95% confidence intervals (CIs) of previous statin use for thyroid cancer were estimated using conditional logistic regression analyses. Additionally, subgroup analyses were conducted. The thyroid cancer group showed more days of previous statin use than the non-thyroid cancer group (72.3, standard deviation [SD] = 181.2 days vs. 64.3, SD = 174.4 days, P = 0.003). Although the odds of previous statin use for thyroid cancer were high in the crude model (OR = 1.10, 95% CI 1.04-1.17, P = 0.002), they were low in the fully adjusted model (OR = 0.89, 95% CI 0.82-0.95, P = 0.001). According to age and sex subgroups, the younger (< 60 years old) male group showed lower odds for thyroid cancer according to previous statin use (adjusted OR = 0.70, 95% CI 0.55-0.88, P = 0.003), but this finding was not observed in other subgroups of older men or in any groups of women. Thyroid cancer was negatively associated with statin use in the previous 2 years in the adjusted model.

Figure 1

A schematic illustration of the participant selection process that was used in the present study. Of a total of 514,866 participants, 5501 thyroid cancer participants were matched with 22,004 non-thyroid cancer participants for age, sex, income, and region of residence. DBP diastolic blood pressure, SBP systolic blood pressure. Thyroid cancer: the thyroid cancer group comprised participants assigned the C73 ICD-10 code who underwent thyroidectomy.

Figure 2

The odds ratios (95% confidence intervals) of (a) statin, (b) hydrophilic statin, and (c) lipophilic statin use for thyroid cancer according to obesity, smoking, alcohol consumption, total cholesterol, blood pressure, and fasting blood glucose.