Table 2.

Association between statin usage after cancer diagnosis and cancer-specific and all-cause mortality in lung cancer patients

Cancer-specific mortalityAll-cause mortality
UnadjustedAdjustedaUnadjustedAdjusteda
Medication usage after diagnosisCancer-specific mortalityAll-cause mortalityAll patientsPerson yearsHR (95% CI)PHR (95% CI)PHR (95% CI)PHR (95% CI)P
Number of patients(n = 3,638)(n = 2,792)(n = 3,638)(n = 2,792)
Statin nonuser1,6691,9622,5234,6191.001.001.001.00
Statin userb5567001,1152,1350.84 (0.76–0.92)<0.0010.89 (0.78–1.02)0.090.89 (0.82–0.97)0.010.91 (0.80–1.02)0.10
Statin user 1 to 11 prescriptionsc3554225359770.84 (0.75–0.94)0.0030.94 (0.81–1.09)0.390.88 (0.79–0.98)0.020.95 (0.83–1.09)0.44
Statin user ≥ 12 prescriptionsc2012785801,1580.84 (0.72–0.97)0.020.81 (0.67–0.98)0.030.91 (0.80–1.04)0.170.84 (0.71–0.99)0.04
Statin user 1 to 365 DDDsc3374064939030.90 (0.80–1.01)0.070.94 (0.81–1.09)0.400.95 (0.85–1.06)0.340.96 (0.84–1.10)0.57
Statin user ≥ 365 DDDsc2192946221,2320.76 (0.66–0.88)<0.0010.82 (0.68–0.98)0.030.82 (0.72–0.93)0.0020.83 (0.70–0.97)0.02
Simvastatin nonuser1,9122,2272,8675,2101.001.001.001.00
Simvastatin userb3434357711,5440.77 (0.68–0.86)<0.0010.80 (0.69–0.93)0.0030.80 (0.72–0.89)<0.0010.81 (0.71–0.92)0.001
Simvastatin 1 to 11 prescriptionsc2202683877770.75 (0.65–0.86)<0.0010.82 (0.69–0.98)0.030.78 (0.69–0.89)<0.0010.84 (0.72–0.98)0.03
Simvastatin ≥ 12 prescriptionsc1231673847670.80 (0.67–0.97)0.020.76 (0.60–0.95)0.010.84 (0.72–0.99)0.040.75 (0.62–0.91)0.004
Atorvastatin nonuser2,0832,4323,3016,1261.001.001.001.00
Atorvastatin userb1722303376280.93 (0.80–1.09)0.370.93 (0.78–1.12)0.471.04 (0.91–1.20)0.521.03 (0.88–1.21)0.68
Pravastatin nonuser2,2162,6153,5646,6201.001.001.001.00
Pravastatin userb3947741331.02 (0.74–1.39)0.931.23 (0.85–1.77)0.271.01 (0.76–1.35)0.941.11 (0.79–1.56)0.53
Rosuvastatin nonuser2,2372,6403,5986,6681.001.001.001.00
Rosuvastatin userb182240860.93 (0.58–1.47)0.741.15 (0.66–2.01)0.610.89 (0.58–1.35)0.580.87 (0.51–1.48)0.61
Fluvastatin nonuser2,2462,6513,6246,7261.001.001.001.00
Fluvastatin userb91114281.16 (0.60–2.23)0.660.98 (0.47–2.09)0.981.17 (0.65–2.12)0.601.07 (0.55–2.06)0.85
Any lipophilicd nonuser1,9012,2142,8511,5731.001.001.001.00
Any lipophilic statin userb3544487875,1810.78 (0.69–0.87)<0.0010.81 (0.70–0.94)0.010.81 (0.73–0.90)<0.0010.82 (0.72–0.93)0.002
Any hydrophilicd nonuser2,0272,3673,2055,9451.001.001,001.00
Any hydrophilic statin userb2282954338090.96 (0.84–1.10)0.541.00 (0.85–1.18)0.971.04 (0.92–1.17)0.541.05 (0.91–1.22)0.49
  • aAdjusted for year of diagnosis, age at diagnosis, gender, radiotherapy within 6 months, chemotherapy within 6 months, surgery within 6 months, comorbidities (before diagnosis, including cerebrovascular disease, chronic pulmonary disease, congestive heart disease, diabetes, myocardial infarction, peptic ulcer disease, peripheral vascular disease, and renal disease), other medication use (after diagnosis, as time varying covariates, specifically low-dose aspirin and beta-blockers), and deprivation (in fifths).

  • bMedication use modeled as a time-varying covariate with an individual considered a nonuser before 6 months after first medication usage, and a user after this time, excludes deaths in the year after cancer diagnosis.

  • cMedication use modeled as a time-varying covariate with an individual considered a nonuser before 6 months after first medication usage, a user of 0 to 12 prescriptions from 6 months after first prescription to 6 months after 12th prescription (or 365th DDD), and a greater user after this time, excludes deaths in the year after cancer diagnosis.

  • dLipophilic statins include simvastatin, fluvastatin, cerivastatin; hydrophilic statins include atorvastatin, pravastatin, and rosuvastatin.