In addition to cholesterol reduction, statins, currently the most commonly prescribed drug in the world, have been shown to have anti-neoplastic and immunomodulatory effects. Several observational studies and meta-analyses have shown reduction in risk of multiple cancers. More recently there has been an increasing interest in the potential role of statins as adjuvant therapy after cancer diagnosis and in modifying cancer mortality. Although post-hoc analyses of randomized controlled trials of statins for cardiovascular outcomes have not shown reduction in the risk of cancer mortality with statin use, these studies lack sufficient power to detect a significant difference in cancer outcomes. Recently, in a Danish nationwide population-based cohort study, Nielsen et al showed a 15% reduction in all-cause and cancer-specific mortality in statin users as compared to non-users. Improved survival with statin exposure was seen in 13/27 cancer subtypes, including the 4 most common cancers - lung, prostate, colorectal and breast. In this commentary, we examine this important study, review its implications and limitations, and briefly discuss impact of other drugs like metformin and aspirin that also exhibit anti-neoplastic effects.
Keywords: Cancer; Chemoprevention; Metformin; Mortality; Statins.