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- Melvin, Jennifer C, et al.
(författare)
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An investigation into the relationship between Statins and Cancer using population-based data
- 2015
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Ingår i: BJU International. - : Wiley. - 1464-4096 .- 1464-410X. ; 116:5, s. 681-683
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Results to date for the association between use of statins and prostate cancer (PCa) death in observational studies are inconsistent. We investigated the application of causal inference methods, which aim to address observational data as if they were from a randomised clinical trial (RCT).MATERIAL AND METHODS: We examined the association between statins and PCa-death in 14,926 men in PCBaSe Sweden. We used inverse probability weighted (IPW) estimation of marginal structural models (MSM), as well incorporating truncated IPW in the presence of time-dependent confounders (TDC) (e.g., disease severity), affected by the exposure.RESULTS: The baseline adjusted odds ratio (OR) was 0.62 (95%CI: 0.51-0.75), which compared risk of PCa-death between men on statins and men not on statins. The calculated IPW for the MSM were highly variable, with the smallest weight at 0.0019 and the largest at 13,574, resulting in an OR of 0.89 (95%CI: 0.69-1.14). Truncating the weights improved variability, reducing the largest weight to 13.16. The truncated MSM OR was 0.86 (95%CI: 0.81-0.91).CONCLUSION: An association of statins and risk of PCa-death could not be reliably discerned, due to lack of data on essential confounders, namely serum cholesterol levels and disease severity. No observational studies on statin-use to date present information on serum cholesterol levels and disease severity in one setting, highlighting the need for careful interpretation of investigations into drugs in relation to diseases other than their intended purpose in observational settings.
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| 2. |
- Stocks, Tanja, et al.
(författare)
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Metabolic risk score and cancer risk : pooled analysis of seven cohorts
- 2015
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Ingår i: International Journal of Epidemiology. - : Oxford University Press. - 0300-5771 .- 1464-3685. ; 44:4, s. 1353-1363
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Tidskriftsartikel (refereegranskat)abstract
- Background: There are few data on the joint influence of metabolic factors on risk of separate cancers. Methods: We analysed data on body mass index, blood pressure and plasma levels of glucose, total cholesterol and triglycerides from seven European cohorts comprising 564 596 men and women with a mean age of 44 years. We weighted those factors equally into a standardized metabolic risk score [MRS, mean = 0, standard deviation (SD) = 1], with an individual's level indicated as SDs from the sex-and cohort-specific means. Cancer hazard ratios were calculated by Cox regression with age as timescale and with relevant adjustments including smoking status. All statistical tests were two-sided. Results: During a mean follow-up of 12 years, 21 593 men and 14 348 women were diagnosed with cancer. MRS was linearly and positively associated with incident cancer in total and at sites (P<0.05). In men, risk per SD MRS was increased by 43% (95% confidence interval: 27-61) for renal cell cancer, 43% (16-76) for liver cancer, 29% (20-38) for colon cancer, 27% (5-54) for oesophageal cancer, 20% (9-31) for rectal cancer, 19% (4-37) for leukaemias, 15% (1-30) for oral cancer and 10% (2-19) for bladder cancer. In women, risk increases per SD MRS were 56% (42-70) for endometrial cancer, 53% (29-81) for pancreatic cancer, 40% (16-67) for renal cell cancer, 27% (9-47) for cervical cancer and 17% (3-32) for rectal cancer. Conclusion: This largest study to date on the joint influence of metabolic factors on risk of separate cancers showed increased risks for several cancers, in particular renal cell and liver cancer in men and endometrial and pancreatic cancer in women.
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