Published OnlineFirst November 13, 2013; DOI: 10.1158/1055-9965.EPI-13-1101
Cancer Epidemiology, Biomarkers & Prevention
Letter to the Editor
Long-term Statin Use and Risk of Breast Cancer—Letter Salvatore Gizzo, Emanuele Ancona, Marco Noventa, Donato D'Antona, and Giovanni Battista Nardelli
We read with great interest the work of McDougall and colleagues recently appeared on your journal reporting that current users of statins for 10 years or longer had a 1.83-fold increased risk of invasive ductal carcinoma (IDC) and a 1.97-fold increased risk of invasive lobular carcinoma (ILC) compared with never users. Among women diagnosed with hypercholesterolemia, current users of statins for 10 years or longer had more than double the risk of both IDC and ILC compared with never users (1). More recently, Desai and colleagues reported in your journal contrasting data obtained by Cox proportional hazards analyses conducted on large-scale population from the WHI study (154,587 postmenopausal women with 7,430 breast cancer pathologically confirmed), concluding that statins were not associated with breast cancer risk (2). A recent review analyses as well as the conflicting results about the chemopreventive statin use in breast cancer population concluded that even if their effects are modest, the overall good long-term tolerability and relative low cost could make them new attractive chemopreventive agents (3). Considering both the increased statin use over the past few decades and the high breast cancer incidence, Authors' Affiliation: Department of Woman and Child Health, University of Padua, Padua, Italy Corresponding Author: Salvatore Gizzo, Dipartimento di Salute della Donna e del Bambino, U.O.C. di Ginecologia e Ostetricia, Via Giustiniani 3, 35128 Padova, Italy. Phone: 39-333-5727248/049-8213400; Fax: 39049-8211785; E-mail: [email protected] doi: 10.1158/1055-9965.EPI-13-1101 Ó2013 American Association for Cancer Research.
morbidity, and mortality, it is mandatory to properly define the exact role of statins in breast cancer risk and recurrence without underestimating the potential implications in ovarian and endometrial tissues. Because of the common hormone-dependent origin and similarities in etiologic factors, gene expression profiles, tumorigenic mechanisms, pathologic changes, and metastatic characteristics, it would be also important to evaluate the effects on ovarian and endometrial tissue. To our knowledge, only one study was properly designed to analyze "Statin use and female reproductive organ cancer risk in a large population-based setting." Authors suggested that there is a nonsignificant reduced risk of endometrial and ovarian cancers among statin users compared with nonusers (4). As well as was discovered raloxifene antiproliferative effect on endometrium during the monitoring of breast antiblastic effects (making it a possible candidate to substitute tamoxifene), something similar could happen on monitoring statins’ effects on hormone-dependent gynecologic malignancies (5). To solve the dilemma, an answer to the lingering questions about the association between gynecologic cancer risk and statin use, a meta-analysis will be necessary combining the existing large-scale studies and further prospective ones. In the same way, further prospective studies, even if conducted on breast cancer and statins, should also consider outcomes about ovary and endometrium to increase the amount of data available in this field. Disclosure of Potential Conflicts of Interest No potential conflicts of interest were disclosed. Received October 18, 2013; revised October 27, 2013; accepted October 31, 2013; published OnlineFirst November 13, 2013.
References 1. McDougall JA, Malone KE, Daling JR, Cushing-Haugen KL, Porter PL, Li CI. Long-term statin use and risk of ductal and lobular breast cancer among women 55 to 74 years of age. Cancer Epidemiol Biomarkers Prev 2013;22:1529–37. 2. Desai P, Chlebowski R, Cauley JA, Manson JE, Wu C, Martin LW, et al. Prospective analysis of association between statin use and breast cancer risk in the women's health initiative. Cancer Epidemiol Biomarkers Prev 2013;22:1868–76.
218
3. Santa-Maria CA, Stearns V. Statins and breast cancer: future directions in chemoprevention. Curr Breast Cancer Rep 2013;5:161–9. 4. Yu O, Boudreau DM, Buist DS, Miglioretti DL. Statin use and female reproductive organ cancer risk in a large population-based setting. Cancer Causes Control 2009;20:609–16. 5. Gizzo S, Saccardi C, Patrelli TS, Berretta R, Capobianco G, Di Gangi S, et al. Update on raloxifene: mechanism of action, clinical efficacy, adverse effects, and contraindications. Obstet Gynecol Surv 2013;68:467–81.
Cancer Epidemiol Biomarkers Prev; 23(1) January 2014
Downloaded from cebp.aacrjournals.org on March 24, 2015. © 2014 American Association for Cancer Research.
Published OnlineFirst November 13, 2013; DOI: 10.1158/1055-9965.EPI-13-1101
Long-term Statin Use and Risk of Breast Cancer−−Letter Salvatore Gizzo, Emanuele Ancona, Marco Noventa, et al. Cancer Epidemiol Biomarkers Prev 2014;23:218. Published OnlineFirst November 13, 2013.
Updated version
Access the most recent version of this article at: doi:10.1158/1055-9965.EPI-13-1101
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Downloaded from cebp.aacrjournals.org on March 24, 2015. © 2014 American Association for Cancer Research.
Cancer Epidemiology, Biomarkers & Prevention
Letter to the Editor
Long-term Statin Use and Risk of Breast Cancer—Letter Salvatore Gizzo, Emanuele Ancona, Marco Noventa, Donato D'Antona, and Giovanni Battista Nardelli
We read with great interest the work of McDougall and colleagues recently appeared on your journal reporting that current users of statins for 10 years or longer had a 1.83-fold increased risk of invasive ductal carcinoma (IDC) and a 1.97-fold increased risk of invasive lobular carcinoma (ILC) compared with never users. Among women diagnosed with hypercholesterolemia, current users of statins for 10 years or longer had more than double the risk of both IDC and ILC compared with never users (1). More recently, Desai and colleagues reported in your journal contrasting data obtained by Cox proportional hazards analyses conducted on large-scale population from the WHI study (154,587 postmenopausal women with 7,430 breast cancer pathologically confirmed), concluding that statins were not associated with breast cancer risk (2). A recent review analyses as well as the conflicting results about the chemopreventive statin use in breast cancer population concluded that even if their effects are modest, the overall good long-term tolerability and relative low cost could make them new attractive chemopreventive agents (3). Considering both the increased statin use over the past few decades and the high breast cancer incidence, Authors' Affiliation: Department of Woman and Child Health, University of Padua, Padua, Italy Corresponding Author: Salvatore Gizzo, Dipartimento di Salute della Donna e del Bambino, U.O.C. di Ginecologia e Ostetricia, Via Giustiniani 3, 35128 Padova, Italy. Phone: 39-333-5727248/049-8213400; Fax: 39049-8211785; E-mail: [email protected] doi: 10.1158/1055-9965.EPI-13-1101 Ó2013 American Association for Cancer Research.
morbidity, and mortality, it is mandatory to properly define the exact role of statins in breast cancer risk and recurrence without underestimating the potential implications in ovarian and endometrial tissues. Because of the common hormone-dependent origin and similarities in etiologic factors, gene expression profiles, tumorigenic mechanisms, pathologic changes, and metastatic characteristics, it would be also important to evaluate the effects on ovarian and endometrial tissue. To our knowledge, only one study was properly designed to analyze "Statin use and female reproductive organ cancer risk in a large population-based setting." Authors suggested that there is a nonsignificant reduced risk of endometrial and ovarian cancers among statin users compared with nonusers (4). As well as was discovered raloxifene antiproliferative effect on endometrium during the monitoring of breast antiblastic effects (making it a possible candidate to substitute tamoxifene), something similar could happen on monitoring statins’ effects on hormone-dependent gynecologic malignancies (5). To solve the dilemma, an answer to the lingering questions about the association between gynecologic cancer risk and statin use, a meta-analysis will be necessary combining the existing large-scale studies and further prospective ones. In the same way, further prospective studies, even if conducted on breast cancer and statins, should also consider outcomes about ovary and endometrium to increase the amount of data available in this field. Disclosure of Potential Conflicts of Interest No potential conflicts of interest were disclosed. Received October 18, 2013; revised October 27, 2013; accepted October 31, 2013; published OnlineFirst November 13, 2013.
References 1. McDougall JA, Malone KE, Daling JR, Cushing-Haugen KL, Porter PL, Li CI. Long-term statin use and risk of ductal and lobular breast cancer among women 55 to 74 years of age. Cancer Epidemiol Biomarkers Prev 2013;22:1529–37. 2. Desai P, Chlebowski R, Cauley JA, Manson JE, Wu C, Martin LW, et al. Prospective analysis of association between statin use and breast cancer risk in the women's health initiative. Cancer Epidemiol Biomarkers Prev 2013;22:1868–76.
218
3. Santa-Maria CA, Stearns V. Statins and breast cancer: future directions in chemoprevention. Curr Breast Cancer Rep 2013;5:161–9. 4. Yu O, Boudreau DM, Buist DS, Miglioretti DL. Statin use and female reproductive organ cancer risk in a large population-based setting. Cancer Causes Control 2009;20:609–16. 5. Gizzo S, Saccardi C, Patrelli TS, Berretta R, Capobianco G, Di Gangi S, et al. Update on raloxifene: mechanism of action, clinical efficacy, adverse effects, and contraindications. Obstet Gynecol Surv 2013;68:467–81.
Cancer Epidemiol Biomarkers Prev; 23(1) January 2014
Downloaded from cebp.aacrjournals.org on March 24, 2015. © 2014 American Association for Cancer Research.
Published OnlineFirst November 13, 2013; DOI: 10.1158/1055-9965.EPI-13-1101
Long-term Statin Use and Risk of Breast Cancer−−Letter Salvatore Gizzo, Emanuele Ancona, Marco Noventa, et al. Cancer Epidemiol Biomarkers Prev 2014;23:218. Published OnlineFirst November 13, 2013.
Updated version
Access the most recent version of this article at: doi:10.1158/1055-9965.EPI-13-1101
Cited Articles
This article cites by 5 articles, 2 of which you can access for free at: http://cebp.aacrjournals.org/content/23/1/218.full.html#ref-list-1
E-mail alerts
Sign up to receive free email-alerts related to this article or journal.
Reprints and Subscriptions Permissions
To order reprints of this article or to subscribe to the journal, contact the AACR Publications Department at [email protected]. To request permission to re-use all or part of this article, contact the AACR Publications Department at [email protected].
Downloaded from cebp.aacrjournals.org on March 24, 2015. © 2014 American Association for Cancer Research.
