Abstract 4829: Statin use and risk of primary liver cancer.
Authors: McGlynn Katherine A. , Divine George W. , Sahasrabuddhe Vikrant V. , Engel Lawrence S. , VanSlooten Ashley , Wells Karen , Ulcickas Yood Marianne , Hensley Alford Sharon 
Published: August 2014

Abstract
Statins (3-hydroxy-3-methylglutaryl coenzyme A reductase (HMG-Co-A) inhibitors) are commonly used cholesterol lowering medications which have demonstrated effectiveness in the primary and secondary prevention of cardiovascular disease. Statins also have anti-angiogenic and anti-proliferative properties which have suggested a possible role for their use as anti-carcinogenic agents. A potential for liver cancer prevention is further indicated as statins, post-administration, are localized to the liver. Promising evidence that statins may decrease risk of primary liver cancer has been reported among high risk populations of hepatitis B virus (HBV) carriers in China. Evidence suggesting such an effect on liver cancer risk in low risk populations in western countries, however, has been inconclusive. In western countries, HBV is less likely to be a major risk factor for liver cancer than are hepatitis C virus (HCV), excessive alcohol consumption and diabetes. To study the relationship between statin use and risk of primary liver cancer in a low risk setting, we conducted a case-control study among members of the Henry Ford Health System health maintenance organization, between the years 1999 and 2010. Liver cancer cases were identified via an internal cancer registry, which is part of Detroit's SEER registry. Controls were persons with no diagnosis of primary liver cancer who were matched to cases on a 5:1 ratio based on sex, age, length of HMO enrollment, and date of liver cancer diagnosis of the case. Statin use was determined via electronic pharmacy records. Analyses included ever having filled a statin prescription, cumulative exposure to statins and time since last prescription. Analyses were adjusted for hypercholesterolemia, type II diabetes, hypertension, HBV, HCV, obesity, alcohol-related conditions and cirrhosis. A total of 75 cases of liver cancer and 373 controls were included in the analyses. The most common risk factor for liver cancer among cases was HCV infection (48%) followed by diabetes (38%) and alcohol-related conditions (25%). Only one case was HBV positive. Conditional logistic regression analysis found that any statin use was associated with a significantly reduced risk of liver cancer (OR=0.40; 95%CI=0.23-0.71). In addition, persons who developed liver cancer had a longer interval since last exposure to statins (617 vs. 542 days; p=0.04) and a shorter cumulative exposure (0.6 vs. 1.3 years, p=0.01) than did controls. These results suggest that statin use, even in populations where HBV is not a major risk factor, is significantly associated with reduced risk of primary liver cancer.
Citation Format: Katherine A. McGlynn, George W. Divine, Vikrant V. Sahasrabuddhe, Lawrence S. Engel, Ashley VanSlooten, Karen Wells, Marianne Ulcickas Yood, Sharon Hensley Alford. Statin use and risk of primary liver cancer. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 4829. doi:10.1158/1538-7445.AM2013-4829