Prostate specific antigen levels reduced by statin therapy
MedWire News: Study results show that statin use reduces prostate-specific antigen (PSA) levels in patients with prostate cancer.
This could lead to the disease being diagnosed at a later and more severe stage in these men, suggest the researchers.
Statins do not appear to have any effect on biochemical disease recurrence (BCR) rates after radical prostatectomy (RP), however, which were the same for men who took statins as for those who did not.
“The results from this study in collaboration with others suggest that patients on statin medications may require a lower threshold for PSA screening,” say Louis Spencer Krane, from the Vattikuti Urology Institute in Detroit, Michigan, and colleagues in The Journal of Urology.
The cohort included 3828 men with biopsy-confirmed prostate cancer who presented for robotic assisted RP. Among these men, 1031 reported statin use before surgery.
The men’s pre-operative characteristics such as age, PSA, body mass index (BMI), pathologic stage, and pathologic Gleason score, were compared, and the researchers evaluated the role of statins in the risk of BCR after RP.
The overall average PSA was significantly lower in men who had taken statins compared with those who had not, at 5.0 versus 5.2 ng/ml. Furthermore, more men on statins presented with Gleason score 7 disease than men not taking the medication, at 58% versus 54%.
Additionally, men on statins were more likely to be overweight (BMI between 25.0 and 29.9 kg/m2), have diabetes, and have surgery later in the cohort.
On multivariate analysis, after controlling for potential confounding factors such as age, BMI, and history of diabetes, statin therapy was associated with a 4.7% decrease in pre-operative PSA.
However, statins had no effect on BCR rates, and even after stratifying by Gleason score and BMI, the association between statin use and BCR did not achieve statistical significance. The low incidence of BCR among the cohort led the researchers to suggest that their analysis may be underpowered.
The researchers acknowledge that the study’s limitations all point toward the necessity of further research to address such issues as the possible association between statins, PSA, and prostate-cancer specific death, and the specific statin dose duration and possible correlations with BCR.
The team concludes: “Further study on the effect of statin therapy on PSA is warranted to ensure that patients on statin medications are being appropriately screened for prostate cancer.”
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By Sarah Guy