Evaluating the impact of pre-diagnostic use of statins and testosterone replacement therapy on mortality outcomes in older men with hormone-related cancers: SEER-Medicare 2007–2015

Details

• Alternative Title:
  Andrology
• Personal Author:
  Hussain, Maryam R. ; Abdelgadir, Omer ; Polychronopoulou, Efstathia ; Tsilidis, Konstantinos K. ; Alzweri, Laith ; Villasante-Tezanos, Alejandro ; Baillargeon, Jacques ; Canfield, Steven ; Kuo, Yong-Fang ; Lopez, David S.
• Description:
  Background:
  
  The link between the pre-diagnostic use of statins and testosterone replacement therapy (TTh) and their impact on hormone-related cancers (HRCs, prostate [PCa], colorectal [CRC], and male breast cancers [BrCa]) survival remain a topic of controversy. Further, there is a knowledge gap concerning the joint effects of statins and TTh on HRCs survival outcomes.
  
  Objective:
  
  To examine the independent and joint effects of pre-diagnostic use of statins and TTh on the risk of all-cause and cause-specific mortality among older men diagnosed with HRCs, including PCa, CRC, and male BrCa.
  
  Methods:
  
  In 41,707 men (≥65 yrs) of SEER-Medicare 2007–2015, we identified 31,097 PCa, 10,315 CRC, and 295 male BrCa cases. Pre-diagnostic prescription of statins and TTh was ascertained and categorized into four groups (Neither users, statins alone, TTh alone and Dual users). Multivariable-adjusted Cox proportional hazards and competing-risks (Fine-Gray subdistribution hazard) models were conducted.
  
  Results:
  
  No significant associations were found in Cox-proportional hazard models for HRCs. However, in the Fine-Gray competing risk models among high grade HRCs, statins alone had an 11% reduced risk of HRC-specific death (HR: 0.89; 95% CI: 0.81–0.99; P: 0.0451). In the PCa cohort with both statistical models, use of TTh alone had a 24% lower risk of all-cause death (HR: 0.76; 95% CI: 0.59–0.97; P: 0.0325) and a 57% lower risk of PCa-specific death (HR: 0.43; 95% CI: 0.24–0.75; P: 0.0029). Similar inverse associations were found among aggressive PCa cases with TTh alone and statins alone. No significant associations were found in the CRC and male BrCa sub-groups.
  
  Conclusion:
  
  Pre-diagnostic use of statins and TTh showed a survival benefit with reduced mortality in high grade HRCs patients (only statins) and aggressive PCa patients in both statistical models. Findings of TTh use in aggressive PCa setting could facilitate clinical trials. Further studies with extended follow-up periods are needed to substantiate these findings.
  
  
• Subjects:
  Aged Aged, 80 And Over Breast Neoplasms, Male Colorectal Neoplasms Hormone Replacement Therapy Humans Hydroxymethylglutaryl-CoA Reductase Inhibitors Male Medicare Prostatic Neoplasms SEER Program Testosterone United States

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• Keywords:
  Colorectal Cancer Male Breast Cancer Prostate Cancer Statins Survival Outcome Testosterone
• Source:
  Andrology. 12(8):1697-1711
• Pubmed ID:
  38421134
• Pubmed Central ID:
  PMC11358361
• Document Type:
  Journal Article
• Funding:
  HHSN261201800032C/CA/NCI NIH HHSUnited States/ ; HHSN261201800009C/CA/NCI NIH HHSUnited States/ ; NU58DP006344/DP/NCCDPHP CDC HHSUnited States/ ; T32 AG000270/AG/NIA NIH HHSUnited States/ ; HHSN261201800015I/CA/NCI NIH HHSUnited States/ ; P30 AG059301/AG/NIA NIH HHSUnited States/ ; NH/NIH HHSUnited States/ ; HHSN261201800032I/CA/NCI NIH HHSUnited States/ ; HHSN261201800015C/CA/NCI NIH HHSUnited States/ ; HHSN261201800009I/CA/NCI NIH HHSUnited States/ ; NH/NIH HHSUnited States/ ; P30 AG059301/AG/NIA NIH HHSUnited States/ ; T32 AG000270/AG/NIA NIH HHSUnited States/ ; RP210130/Cancer Prevention and Research Institute of Texas/
• Volume:
  12
• Issue:
  8
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:2dcaab2afbc4ba0d4d948d5573ad2fee6af12d48e7a1bb6d76001766245d2680adace28982c1ad65668fe3cbd36eab404c585885d5d43a50268438794c39dd56
• Download URL:
  https://stacks.cdc.gov/view/cdc/160683/cdc_160683_DS1.pdf
• File Type:
  [PDF - 1.67 MB ]