Statin use and risk of liver cancer

Evidence from two population-based studies

Kim Tu Tran, Úna C. McMenamin, Helen G. Coleman, Chris R. Cardwell, Peter Murchie, Lisa Iversen, Amanda J. Lee, Aaron P. Thrift (Corresponding Author)

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Epidemiological studies of statin use and liver cancer risk have produced conflicting results. We examined the association between statin use and risk of primary liver cancer in two large independent study populations taking account of important covariates and main indications of statins such as high cholesterol and chronic liver disease. We performed a nested case–control study within the Scottish Primary Care Clinical Informatics Unit (PCCIU) database. Five controls were matched to cases with primary liver cancer and we used conditional logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for associations with statin use. We also conducted a prospective cohort study within the UK Biobank using self‐reported statin use and cancer‐registry recorded primary liver cancer outcomes. Cox regression was used to calculate hazard ratios (HRs) and 95% CIs. In the PCCIU case–control analysis, 434 liver cancer cases were matched to 2,103 controls. In the UK Biobank cohort, 182 out of 475,768 participants developed incident liver cancer. Statin use was associated with 39% lower risk of liver cancer in the PCCIU (adjusted OR 0.61, 95% CI 0.43–0.87). When we examined specific subtypes of liver cancer in the UK Biobank, statin use was associated with lower risk of hepatocellular carcinoma (HCC; adjusted HR, 0.48; 95% CI, 0.24–0.94) but not intrahepatic bile duct carcinoma (IBDC; adjusted HR, 1.09; 95% CI, 0.45–2.64). In conclusion, we found a consistent inverse relationship between statin use and risk of primary liver cancer which was only seen for HCC but not IBDC.
Original languageEnglish
JournalInternational Journal of Cancer
Early online date4 Jun 2019
DOIs
Publication statusE-pub ahead of print - 4 Jun 2019

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Liver Neoplasms
Population
Medical Informatics
Confidence Intervals
Primary Health Care
Odds Ratio
Intrahepatic Bile Ducts
Liver Diseases
Epidemiologic Studies
Hepatocellular Carcinoma
Chronic Disease
Cohort Studies
Logistic Models
Cholesterol
Databases
Prospective Studies
Carcinoma

Keywords

  • statins
  • liver cancer
  • hepatocellular carcinoma
  • intrahepatic bile duct carcinoma

Cite this

Statin use and risk of liver cancer : Evidence from two population-based studies. / Tran, Kim Tu; McMenamin, Úna C.; Coleman, Helen G.; Cardwell, Chris R.; Murchie, Peter; Iversen, Lisa; Lee, Amanda J.; Thrift, Aaron P. (Corresponding Author).

In: International Journal of Cancer, 04.06.2019.

Research output: Contribution to journalArticle

Tran, Kim Tu ; McMenamin, Úna C. ; Coleman, Helen G. ; Cardwell, Chris R. ; Murchie, Peter ; Iversen, Lisa ; Lee, Amanda J. ; Thrift, Aaron P. / Statin use and risk of liver cancer : Evidence from two population-based studies. In: International Journal of Cancer. 2019.
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AU - Thrift, Aaron P.

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N2 - Epidemiological studies of statin use and liver cancer risk have produced conflicting results. We examined the association between statin use and risk of primary liver cancer in two large independent study populations taking account of important covariates and main indications of statins such as high cholesterol and chronic liver disease. We performed a nested case–control study within the Scottish Primary Care Clinical Informatics Unit (PCCIU) database. Five controls were matched to cases with primary liver cancer and we used conditional logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for associations with statin use. We also conducted a prospective cohort study within the UK Biobank using self‐reported statin use and cancer‐registry recorded primary liver cancer outcomes. Cox regression was used to calculate hazard ratios (HRs) and 95% CIs. In the PCCIU case–control analysis, 434 liver cancer cases were matched to 2,103 controls. In the UK Biobank cohort, 182 out of 475,768 participants developed incident liver cancer. Statin use was associated with 39% lower risk of liver cancer in the PCCIU (adjusted OR 0.61, 95% CI 0.43–0.87). When we examined specific subtypes of liver cancer in the UK Biobank, statin use was associated with lower risk of hepatocellular carcinoma (HCC; adjusted HR, 0.48; 95% CI, 0.24–0.94) but not intrahepatic bile duct carcinoma (IBDC; adjusted HR, 1.09; 95% CI, 0.45–2.64). In conclusion, we found a consistent inverse relationship between statin use and risk of primary liver cancer which was only seen for HCC but not IBDC.

AB - Epidemiological studies of statin use and liver cancer risk have produced conflicting results. We examined the association between statin use and risk of primary liver cancer in two large independent study populations taking account of important covariates and main indications of statins such as high cholesterol and chronic liver disease. We performed a nested case–control study within the Scottish Primary Care Clinical Informatics Unit (PCCIU) database. Five controls were matched to cases with primary liver cancer and we used conditional logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for associations with statin use. We also conducted a prospective cohort study within the UK Biobank using self‐reported statin use and cancer‐registry recorded primary liver cancer outcomes. Cox regression was used to calculate hazard ratios (HRs) and 95% CIs. In the PCCIU case–control analysis, 434 liver cancer cases were matched to 2,103 controls. In the UK Biobank cohort, 182 out of 475,768 participants developed incident liver cancer. Statin use was associated with 39% lower risk of liver cancer in the PCCIU (adjusted OR 0.61, 95% CI 0.43–0.87). When we examined specific subtypes of liver cancer in the UK Biobank, statin use was associated with lower risk of hepatocellular carcinoma (HCC; adjusted HR, 0.48; 95% CI, 0.24–0.94) but not intrahepatic bile duct carcinoma (IBDC; adjusted HR, 1.09; 95% CI, 0.45–2.64). In conclusion, we found a consistent inverse relationship between statin use and risk of primary liver cancer which was only seen for HCC but not IBDC.

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