Prolonged statin use is associated with a decreased risk of prostate cancer (PCa), but the extent of this protective effect varies by duration of use time and type of statin, according to a new study.

A team led by Alexander Lustman, MD, of Clalit Health Services in Tel Aviv, Israel, conducted a population-based cohort study of 66,741 men aged 45-85 years. The mean age at cohort entry was 58 years. During follow-up, 1,813 PCa cases were diagnosed and 11,245 men died. A total of 37,645 subjects (56%) had filled at least one prescription for a statin and 26,061 (39%) had filled prescriptions for statins for at least 12 months.

The longer statins were used, the greater the reduction in PCa risk. In a fully adjusted model, men who used statins for five years or more had a 78% decreased risk of a PCa diagnosis compared with non-users. Men who used statins for one to five years had a 45% decreased risk and those who used statins for three to 12 months had a 32% decreased risk, the researchers reported online ahead of print in Prostate Cancer and Prostatic Disease.

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Risk reductions also varied by cumulative statin use. Compared with men who did not take statins, those who had a cumulative defined daily dose of 1-5,000, 5,001-10,000, 10,001-20,000, and 20,001 mg or higher had an 18%, 36%, 65%, and 76% decreased risk, respectively, in a fully adjusted model.

Moreover, the reduction in risk varied by type of statin. Compared with no statin use, men who used rosuvastatin for at least six months had an 80% decreased risk of PCa in a fully adjusted model. Men who used simvastatin or atorvastatin for at least six months had a 52% and 55% decreased risk. The risk was increased by 34% and 29% for men who used lovastatin or fluvastatin, respectively.