Statin use and risk of liver cancer: evidence from two population-based studies.


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Kim Tu Tran1,Úna McMenamin1,Helen Coleman1,Chris Cardwell1,Peter Murchie2,Lisa Iversen2,Amanda Lee2,Aaron Thrift3
1Queen's University Belfast,2University of Aberdeen,3Baylor College of Medicine

Abstract

Background

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.

Method

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.

Results

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 (adjusted HR, 0.48; 95% CI, 0.24-0.94) but not intrahepatic bile duct carcinoma (adjusted HR, 1.09; 95% CI, 0.45-2.64).

Conclusion

In conclusion, we found a consistent inverse relationship between statin use and risk of primary liver cancer which was only seen for hepatocellular carcinoma but not intrahepatic bile duct carcinoma.