Statin medications are associated with a lower probability of having an abnormal screening prostate-specific antigen result

Ying Shi; Kathy Z Fung; Stephen J Freedland; Richard M Hoffman; Victoria L Tang; Louise C Walter

doi:10.1016/j.urology.2014.06.069

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Statin medications are associated with a lower probability of having an abnormal screening prostate-specific antigen result

Journal article

Open access

Peer reviewed

Statin medications are associated with a lower probability of having an abnormal screening prostate-specific antigen result

Ying Shi, Kathy Z Fung, Stephen J Freedland, Richard M Hoffman, Victoria L Tang and Louise C Walter

Urology (Ridgewood, N.J.), Vol.84(5), pp.1058-1065

11/2014

DOI: 10.1016/j.urology.2014.06.069

PMCID: PMC4254664

PMID: 25443902

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Abstract

To investigate how statin use is associated with the probability of having an abnormal screening prostate-specific antigen (PSA) result according to common PSA thresholds for biopsy (>2.5, >4.0, and >6.5 ng/mL). We conducted a cross-sectional study of 323,426 men aged ≥65 years who had a screening PSA test in 2003 at a Veterans Affairs facility. The primary predictor was the use of statin medications at the time of index screening PSA test. The main outcome was the screening PSA value. Poisson regressions were performed to calculate adjusted relative risks for having an abnormal screening PSA result according to statin usage. Percentages of men with PSA results exceeding commonly used thresholds of >2.5, >4.0, and >6.5 ng/mL were 21.0%, 7.6%, and 1.6%, respectively. These percentages decreased with statin use, increasing statin dose, duration of statin use, and potency of the statin. For example, after adjusting for age, the percentage of men having a PSA level >4.0 ng/mL ranged from 8.2% in non-statin users to 6.2% in men prescribed with >40 mg of simvastatin dose. Adjusted relative risks of having a PSA level >4.0 ng/mL were 0.89 (95% confidence interval [CI], 0.86-0.93), 0.87 (95% CI, 0.84-0.91), and 0.83 (95% CI, 0.80-0.87), respectively for men on simvastatin dose of 5-20, >20-40, and >40 mg vs non-statin users. Statin use is associated with a reduction in the probability that an older man will have an abnormal screening PSA result, regardless of the PSA threshold. This reduction is more pronounced with higher statin dose, longer statin duration, and higher statin potency.

Cross-Sectional Studies

United States

Humans

Probability

Male

Risk

Treatment Outcome

Prostatic Neoplasms - diagnosis

Simvastatin - pharmacology

Prostate-Specific Antigen - blood

Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects

Biopsy

Aged, 80 and over

Prostatic Neoplasms - blood

Poisson Distribution

Aged

Hospitals, Veterans

Cohort Studies

Details

Title: Subtitle: Statin medications are associated with a lower probability of having an abnormal screening prostate-specific antigen result
Creators: Ying Shi - Division of Geriatrics, San Francisco VA Medical Center and University of California, San Francisco, CA. Electronic address: Ying.Shi2@va.gov
Kathy Z Fung - Division of Geriatrics, San Francisco VA Medical Center and University of California, San Francisco, CA
Stephen J Freedland - Durham VA Medical Center and Duke Prostate Center, Duke University, Durham, NC
Richard M Hoffman - New Mexico VA Health Care System and Department of Medicine, University of New Mexico, Albuquerque, NM
Victoria L Tang - Division of Geriatrics, San Francisco VA Medical Center and University of California, San Francisco, CA
Louise C Walter - Division of Geriatrics, San Francisco VA Medical Center and University of California, San Francisco, CA
Resource Type: Journal article
Publication Details: Urology (Ridgewood, N.J.), Vol.84(5), pp.1058-1065
DOI: 10.1016/j.urology.2014.06.069
PMID: 25443902
PMCID: PMC4254664
NLM abbreviation: Urology
ISSN: 0090-4295
eISSN: 1527-9995
Grant note: K24CA160653 / NCI NIH HHS P30 AG044281 / NIA NIH HHS K24AG041180 / NIA NIH HHS R01 CA134425 / NCI NIH HHS K24 CA160653 / NCI NIH HHS K24 AG041180 / NIA NIH HHS
Language: English
Date published: 11/2014
Academic Unit: Epidemiology; General Internal Medicine; Internal Medicine
Record Identifier: 9984094515702771

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