SAN FRANCISCO, CA—Statin use and liver cancer were independently associated with older age, race, higher prevalence of diabetes, liver cirrhosis, smoking, BMI, and more total healthcare utilization, a study reported at The Liver Meeting® 2015.
Previous studies have shown that statin use has been associated with a decreased risk of developing hepatocellular carcinoma (HCC), both in patients with cardiovascular risk factors and with hepatitis C virus (HCV) infection, noted Anders H. Nyberg, MD, Kaiser Permanente, San Diego, CA. In patients with liver disease, however, there is a paucity of data.
In this study, Dr. Nyberg and colleagues evaluated the effect of statin use on rates of HCC in their HCV population at Kaiser Permanente Southern California (KPSC), a community-based health care system.
The KPSC database was used to identify 35,712 patients ≥18 years with a chronic HCV diagnosis by ICD-9 code or positive HCV RNA test between 2002–2012. The KPSC National Cancer Institute Surveillance, Epidemiology, and End Results (KPSC-NCI SEER)-affiliated cancer registry was used to identify new cases of HCC between 2008–2012.
“Statin use was defined as having two or more filled prescriptions prior to the outcome or the end of the follow-up,” the investigators reported. “Clinical and sociodemographic patient characteristics were measured prior to and during the study period.”
The results showed that “statin use prevailed as a strong protective effect after adjustment of clinical and sociodemographic characteristics.”
Logistic regression modeling was used to assess crude and adjusted odds ratios of liver cancer associated with statin use. Compared with OR 0.485 (95% CI: 0.341–0.690; P<0.0001) in the unadjusted model (n=35,712), the OR for statin use (yes vs. no) was 0.258 (95% CI: 0.169–0.394; P<0.001) in the adjusted model (n=25,553).
Also, in the adjusted model, age was OR 1.029 (95% CI: 1.017–1.041; P<0.0001); BMI, OR 0.983 (95% CI: 0.964–1.002; P=0.0868); Charlson Comorbidity Index, OR 1.061 (95% CI: 1.011–1.113; P=0.016); other vs. white race, OR 0.309 (95% CI: 0.126–0.759; P=0.0045); diabetes (yes vs. no), OR 1.31 (95% CI: 1.10–1.716; P=0.0497); and liver cirrhosis (yes vs. no), OR 6.755 (95% CI: 4.985–9.153; P<0.0001).
Dr. Nyberg concluded that cirrhosis and age were “strongly associated with an increased risk of developing liver cancer” and that use of statins was linked to a lower risk of HCC.