The study showed that any use of statins in the random-effects logistic regression model was associated with significantly increased NMSC incidence (OR, 1.21) over a mean follow-up of 10.5 years. The researchers found that increased risk was associated with lovastatin (OR, 1.52) and simvastatin (OR, 1.38).
In addition, lipophilic statin users had a significant increase compared with non-statin users (OR, 1.39). Low potency was associated with an OR of 1.33. However, high potency statins were only associated with an OR of 1.20 compared with non-statin users.
“We did not find a relationship specifically with longer duration or higher dosing/potency, but we did find that lipophilic statins in particular were associated with increased risk,” Wang told Cancer Therapy Advisor.
“Oncologists and also primary care physicians may want to consider prescribing non-lipophilic statins for patients at high risk of NMSC, based on skin type, family history, and risk factors. These findings also underlie the importance of patients using sun protection while taking statins. However, this relationship must be further evaluated in a randomized control trial format before making definitive clinical recommendations.”
Wang said the mechanisms of action are still unclear, though multiple mechanisms have been proposed. The study showed no significant effect modification of the statin–NMSC relationship when they looked at age, body mass index, smoking, solar irradiation, vitamin D use, and skin cancer history.
Kirsten Moysich, PhD, MS, professor of oncology in the Department of Cancer Prevention and Control and a professor in the Department of Immunology at Roswell Park Cancer Institute in Buffalo, NY, said this is a well-designed study with statin use information from the time before women developed NMSC. Dr Moysich said the findings are intriguing; however, they will now need to be verified.
“While there was elevated risk among women who used lipophilic statins, there was no trend for increasing risk as a function of greater duration of use. The authors of this paper acknowledge that this lack of a dose-response relationship might be due to the fact that other factors that could not be accounted for in the analyses might be responsible for these findings,” Dr Moysich told Cancer Therapy Advisor.
RELATED: Skin Cancer Risk Lower With Sirolimus in Organ Transplant Recipients
“In light of the fact that heart disease is by far more fatal than NMSC, these findings do not lend support for a re-evaluation of the risk-benefit ratio of statin use. As always, women should discuss any concerns about medication use with their physicians.”
- Wang A, Stefanic ML, Kapphahn K, et al. Relation of statin use with non-melanoma skin cancer: prospective results from the Women’s Health Initiative. Br J Cancer. 2016;114(3):314–320.