Abstract 6490: Post-diagnosis statin use and survival among head and neck cancer patients: A cohort study in the US military health system
Authors: Lin Jie , Shriver Craig D. , Zhu Kangmin 
Published: April 2023

Abstract
Head and neck squamous cell carcinoma (HNSCC) arises from the mucosal lining of the aerodigestive tract. Statin is a class of commonly prescribed medications used for treatment of high cholesterol. Studies have shown that statin exhibits anticancer effects, and the use of statin is associated with improved survival of common cancers, such as prostate, breast and colorectal cancers. However, few research has been conducted on statin use in relation to the survival of HNSCC. This study assessed whether statin use after HNSCC diagnosis is associated with overall survival among patients with HNSCC in the U.S. military health system (MHS). The MHS provides universal health care to its beneficiaries with no or little out-of-pocket cost, thus a study in the MHS reduces the effects of prescription drug access related to patients’ insurance coverage, race and socio-economic status. This study included 1,842 adult patients (18 or older) with histologically confirmed HNSCC identified from the MilCanEpi database which contains information from the Department of Defense’s Central Cancer Registry (CCR) and the Military Health System Data Repository (MDR). Patients were diagnosed between January 1, 2002 and December 31, 2014 and followed up through December 31, 2015. Statin use was extracted from the MDR pharmacy data containing prescription records from all sources. Among the 1,842 patients, 389 patients used statin after HNSCC diagnosis. Time-dependent multivariate Cox proportional hazards models were used to assess the relationship between post-diagnosis statin use and overall survival, reducing the potential effects of immortal time bias. Statistical adjustment was made for covariables including age, sex, race, Hispanic ethnicity, active-duty status, history of cardiovascular diseases, Charlson comorbidity index, baseline statin use, tumor site, tumor stage and cancer treatments. Increased post-diagnosis cumulative use of statin (per one-year of use) conferred a significant improved survival with adjusted hazard ratio (HR) of 0.70 (95% CI=0.55 to 0.90). When analysis was stratified by status of statin use prior to HNSCC diagnosis, the HRs were 0.36 (95% CI=0.19-0.69) and 0.81 (95% CI=0.59-1.11) for those who used and did not use it before the diagnosis, respectively. While the numbers of patients for each group of this stratified analysis were not large, our study suggest that prolonged duration of Statinuse may be associated with improved survival among HNSCC patients. Future research with a larger number of patients is warranted.
Disclaimer: The contents of this publication are the sole responsibility of the authors and do not necessarily reflect the views, opinions, or policies of the USUHS, HJF, the DoD or the Departments of the Army, Navy, or Air Force. Mention of trade names, commercial products, or organizations does not imply endorsement by the U.S. Government.
Citation Format: Jie Lin, Craig D. Shriver, Kangmin Zhu. Post-diagnosis statin use and survival among head and neck cancer patients: A cohort study in the US military health system. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 6490.