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Keywords:

  • prostate cancer;
  • statin;
  • NSAID;
  • all-cause mortality;
  • prostatectomy;
  • radiotherapy

Study Type – Prevalence (prospective cohort) Level of Evidence 1b

OBJECTIVE

To determine whether 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) and nonsteroidal anti-inflammatory drugs (NSAIDs) are associated with the risk of prostate cancer and improved survival in men with prostate cancer.

PATIENTS AND METHODS

We retrospectively examined the association between NSAID and statin use among 7042 men who underwent radical prostatectomy (RP, 4611) or radiotherapy (RT, 2431) for prostate cancer between 1990 and 2003 identified in the Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE), a primarily community-based national prostate cancer registry. We compared clinical and sociodemographic variables by statin and NSAID use, using chi-square tests and multinomial logistic regression. We examined associations between medications and comorbid illness with mortality using unadjusted and adjusted Cox proportional hazard models.

RESULTS

The median (range) follow-up from treatment was 4 (0–16) years. In multivariate survival analysis, statin ‘ever-use’ was associated with a reduced risk of all-cause mortality (ACM) after RP (hazard ratio, HR, 0.35, 95% confidence interval, CI, 0.21–0.58) and RT (0.59, 0.37–0.94). NSAID ever-use was also associated with a reduced risk of ACM after RP (HR 0.47, 95% CI 0.30–0.75) and RT (0.39, 0.25–0.59).

CONCLUSIONS

In a population of men with prostate cancer, statin and NSAID ever-use were associated with a reduced risk of ACM. Our study highlights the importance of multidisciplinary survivorship care for men with prostate cancer.