There may be a surprising reason for the ongoing decline in
U.S. prostate cancer deaths: increased use of cholesterol-lowering statin
Since 1993, fewer and fewer American men have been dying of prostate cancer.
An obvious reason is that during this time, more men have undergone prostate
cancer screening with the PSA blood test. PSA (prostate-specific antigen)
levels can rise sharply as prostate cancers begin to grow. But noncancer
conditions, such as an enlarged prostate, can also make PSA levels go up.
Screening is indeed linked to the decline in prostate cancer deaths -- at
least for white men, find Jared Cox, MD, and colleagues at the University of
Alabama in Birmingham. And for black Americans, health insurance coverage is
linked to fewer prostate cancer deaths.
But there's another explanation besides PSA screening. Cox and colleagues
also find that men with higher cholesterol levels have a lower risk of prostate
cancer. Men with high cholesterol usually get treated with cholesterol-lowering
Examples of statins include Zocor, Lipitor, Pravachol, Crestor, Lescol, and
In the test tube, statin drugs keep prostate cancer cells from growing. It's
possible, Cox and colleagues suggested at this week's meeting of the American
Urological Association (AUA), that the drugs could be protecting men against
That's exactly what two other research groups reported at the AUA
Statins vs. Prostate Cancer
Robert J. Hamilton, MD, MPH, and colleagues at Duke and Johns Hopkins
universities studied more than 1,500 men treated with statins at the Durham,
N.C., VA Medical Center. None of the men had any sign of prostate cancer at the
beginning of the study, but all of them were undergoing regular PSA screening
After starting statin treatment, the men averaged a 31% drop in cholesterol
levels. They also had a slight drop in PSA levels.
As it turned out, the greater the men's cholesterol decrease, the more their
PSA levels dropped.
"Statins may influence prostate biology," Hamilton and colleagues
Taking a different approach, Teemu J. Murtola, MD, and colleagues at the
University of Tampere, Finland, analyzed data from a study of 22,536 men aged
55 to 67. These men underwent PSA screening as part of a clinical trial.
Six years later, 4.7% of men who did not take statin drugs had developed
prostate cancer. Among the more than 5,000 men who regularly took statin drugs,
only 2.8% developed prostate cancer.
"Prostate cancer incidence was decreased among statin users, suggesting
a chemopreventive effect," Murtola and colleagues suggest.
By Daniel DeNoon
Reviewed by Louise Chang
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