The effect of statins on risk and survival of gynecological malignancies

Purpose. The use of statins has been associated with reduced risk of malignancies in a variety of organ sites. This study was aimed at studying the effects of statins on gynecological cancers. Methods. The Cancer in The Ovary and Uterus Study (CITOUS) is a case-control study of newly diagnosed cases of gynecological malignancies and age/sex/clinic/ethnic-group matched population controls. Use of statins prior to and following diagnosis was assessed in a subset of 424 cases of ovarian and endometrial cancers and 341 controls, enrolled in Clalit Health Services (CHS), using pharmacy records. Results. The use of statins for more than one year prior to diagnosis was associated with a significantly reduced risk of ovarian cancer (OR = 0.56, 95% Cl: 0.33-0.94) and of endometrial cancer (OR = 0.59, 95% Cl: 0.40-0.87). The association with endometrial cancer, but not with ovarian cancer (OR = 0.54, 0.26-1.13), remained statistically significant after adjustment for fruit and vegetable consumption, sports activity, family history of endometrial and colorectal cancer, ethnicity, BMI, duration of breast feeding, age at 1st pregnancy and use of menopausal hormones (RR = 0.48, 0.26-0.89). Women who used statins only after diagnosis of cancer had a significantly better survival of both ovarian cancer (Log rank test, p = 0.021, age adjusted HR = 0.47, 0.26-0.85) and endometrial cancer (p = 0.06, age adjusted HR = 0.45, 0.23-0.87). Conclusion. The use of statins for more than one year before diagnosis was associated with a reduction in the risk of endometrial cancer and possibly ovarian cancer. A significantly improved survival of cases of both malignancies was noticed when statins were taken only after diagnosis. (C) 2013 Elsevier Inc. All rights reserved.