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Commentary—Does Statin Use Protect Against Death From Prostate Cancer?

29/01/20 Leonard G. Gomella, MD, FACS The Bernard W. Godwin Professor of Prostate Cancer and Chair, Department of Urology, Jefferson Medical College, Senior Director Clinical Affairs, Sidney Kimmel Cancer Center, Jefferson University Hospital

Among men in the United States, prostate cancer is the most common cancers and one of the most common causes of cancer deaths. Every year, more than 174,650 new cases are diagnosed, and 31,620 people die of prostate cancer (2019 estimates). Thus, researchers have long sought a way to prevent the development of prostate cancer. Many studies have been done, but no effective prevention methods have been discovered.

 However, researchers have long noticed that men who take statin drugs to lower the level of lipids in the blood to help prevent coronary artery disease seem to be less likely to die of prostate cancer. Although doctors are not sure why this cholesterol-lowering drug might help prevent prostate cancer, these findings have led researchers to conduct a recently published large study of statin use and the development of prostate cancer. Doctors followed over 40,000 men from 1990 through 2014 and noted whether they took a statin and whether and when they developed prostate cancer. This study found that men who took statins were less likely to die of prostate cancer. However, the study did not find a reduction in the number of men who developed prostate cancer. Because this study did not randomly assign men to take or not take statins, these results, although suggesting a possible benefit from statins, are not definitive. More studies are needed to determine whether statins are effective in preventing death due to prostate cancer.

Fortunately, the prognosis for most men with prostate cancer is very good. Most older men with prostate cancer tend to live as long as other men their age who have similar general health and do not have prostate cancer. Men who are already taking statins to protect against coronary artery disease may gain an unanticipated benefit in lowering their risk of prostate cancer. But it is not yet known whether men who have no other reason to take a statin should start taking one solely to help prevent prostate cancer.

In 2020, our best defense against dying from prostate cancer remains screening. Screening has the advantage of finding aggressive cancers early—when they might be cured. However, because screening tests are positive in many men who do not have cancer and because some prostate cancers grow so slowly that they may not require treatment, experts disagree about whether and when screening is helpful.