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Cancer Epidemiology, Biomarkers & Prevention
Cancer Epidemiology, Biomarkers & Prevention
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Research Article

Statin Use and Chronic Lymphocytic Leukemia Incidence: A Nested Case–Control Study in Manitoba, Canada

Christiaan H. Righolt, Geng Zhang, Xibiao Ye, Versha Banerji, James B. Johnston, Spencer Gibson and Salaheddin M. Mahmud
Christiaan H. Righolt
1Department of Community Health Sciences, Vaccine and Drug Evaluation Centre, University of Manitoba, Winnipeg, Manitoba, Canada.
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  • ORCID record for Christiaan H. Righolt
Geng Zhang
1Department of Community Health Sciences, Vaccine and Drug Evaluation Centre, University of Manitoba, Winnipeg, Manitoba, Canada.
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Xibiao Ye
1Department of Community Health Sciences, Vaccine and Drug Evaluation Centre, University of Manitoba, Winnipeg, Manitoba, Canada.
2School of Health Information Science, University of Victoria, Victoria, British Columbia, Canada.
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Versha Banerji
3Research Institute of Oncology and Hematology, CancerCare Manitoba, Winnipeg, Manitoba, Canada.
4Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
5Department of Biochemistry and Medical Genetics, University of Manitoba, Winnipeg, Manitoba, Canada.
6Department of Hematology and Oncology, CancerCare Manitoba, Winnipeg, Manitoba, Canada.
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James B. Johnston
3Research Institute of Oncology and Hematology, CancerCare Manitoba, Winnipeg, Manitoba, Canada.
4Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
6Department of Hematology and Oncology, CancerCare Manitoba, Winnipeg, Manitoba, Canada.
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Spencer Gibson
3Research Institute of Oncology and Hematology, CancerCare Manitoba, Winnipeg, Manitoba, Canada.
6Department of Hematology and Oncology, CancerCare Manitoba, Winnipeg, Manitoba, Canada.
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Salaheddin M. Mahmud
1Department of Community Health Sciences, Vaccine and Drug Evaluation Centre, University of Manitoba, Winnipeg, Manitoba, Canada.
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  • For correspondence: Salah.Mahmud@gmail.com
DOI: 10.1158/1055-9965.EPI-19-0107
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Abstract

Background: Recent studies have reported reduced risk of chronic lymphocytic leukemia (CLL) among statin users. However, the possibility that the effect of statins may differ by their chemical or pharmacodynamic properties has not been investigated.

Methods: In this nested case–control study, all Manitobans ages ≥40 years when diagnosed with CLL (as a first cancer) from 1999 to 2014 (n = 1,385) were matched (on gender, age, residence, and duration of insurance coverage) to cancer-free controls (n = 6,841). Using conditional logistic regression, statin use was analyzed by individual statins and groups: hydrophilic, low-potency lipophilic (fluvastatin and lovastatin), and high-potency lipophilic statins.

Results: Statin users constituted 27% and 28% of the CLL cases and controls, respectively. After adjusting for potential confounding by indication, patterns of healthcare utilization, and use of other drugs, CLL incidence was not associated with use of hydrophilic [odds ratio (OR) = 1.08; 95% confidence interval (CI), 0.86–1.34] or high-potency lipophilic (OR = 0.94; 95% CI, 0.79–1.11) statins. Low-potency lipophilic statins were associated with a lower risk of CLL (OR = 0.64; 95% CI, 0.45–0.92), with stronger association (OR = 0.44; 95% CI, 0.22–0.88) observed with more regular use (half to full standard dose on average).

Conclusions: We found an association between low-potency lipophilic statin use and reduced CLL risk, with a possible dose–response effect.

Impact: Although requiring replication in future studies, our findings suggest that the effect of statins on CLL risk may depend on their specific chemical or pharmacodynamic properties.

Footnotes

  • Note: Supplementary data for this article are available at Cancer Epidemiology, Biomarkers & Prevention Online (http://cebp.aacrjournals.org/).

  • Cancer Epidemiol Biomarkers Prev 2019;28:1–7

  • Received January 22, 2019.
  • Revision received March 27, 2019.
  • Accepted June 6, 2019.
  • Published first June 11, 2019.
  • ©2019 American Association for Cancer Research.
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This OnlineFirst version was published on August 7, 2019
doi: 10.1158/1055-9965.EPI-19-0107

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Statin Use and Chronic Lymphocytic Leukemia Incidence: A Nested Case–Control Study in Manitoba, Canada
Christiaan H. Righolt, Geng Zhang, Xibiao Ye, Versha Banerji, James B. Johnston, Spencer Gibson and Salaheddin M. Mahmud
Cancer Epidemiol Biomarkers Prev August 7 2019 DOI: 10.1158/1055-9965.EPI-19-0107

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Statin Use and Chronic Lymphocytic Leukemia Incidence: A Nested Case–Control Study in Manitoba, Canada
Christiaan H. Righolt, Geng Zhang, Xibiao Ye, Versha Banerji, James B. Johnston, Spencer Gibson and Salaheddin M. Mahmud
Cancer Epidemiol Biomarkers Prev August 7 2019 DOI: 10.1158/1055-9965.EPI-19-0107
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