Epidemiology

Statins tied to lower liver cancer risk with hep C

Last Updated: 2013-03-22 7:00:13 -0400 (Reuters Health)

By Genevra Pittman

NEW YORK (Reuters Health) - People with chronic hepatitis C are less likely to develop liver cancer if they are taking statins, research from Taiwan suggests.

Previous studies have come to ambiguous and conflicting conclusions on the question of statins' cancer-preventing abilities.

"Observational studies do suggest a significant, modest reduction in the risk of (hepatoma) among patients with chronic liver disease who take statins," said Dr. Hashem El-Serag, a liver disease researcher from the Baylor College of Medicine and Michael E. DeBakey VA Medical Center in Houston.

At the National Taiwan University College of Public Health in Taipei, Dr. Pau-Chung Chen and colleagues used nationwide data to track nearly 261,000 people with hepatitis C from 1999 through 2010.

During that span, about 13% of them filled a prescription for statins.

A total of 28,000 people were diagnosed with liver cancer by 2011 - or about 1% of those with hepatitis C each year. After adjustment for age, gender and comorbidities, those who took statins were about half as likely to get cancer as non-statin users.

Higher doses of statins, as well as longer-term use, were linked to a further drop in cancer risk, according to the findings published March 18th in the Journal of Clinical Oncology.

The researchers said statins may prevent the hepatitis C virus from replicating or slow the growth of malignant cells. But they can't prove the drugs stopped people from getting cancer.

One limitation, they noted, is that they weren't able to measure other health and lifestyle factors that influence people's risk of liver cancer, including their weight and whether they smoked or drank heavily.

The researchers did not find a link between statins and any serious complications, however.

"We feel more confident that statins do not cause harm in patients with liver disease," Dr. Chen told Reuters Health in an email.

Until recently, Dr. El-Serag said, many doctors feared prescribing statins to people with liver disease, believing they might cause liver-related complications. He agreed that the new study should allay those concerns.

"The downside to the observational studies, including this study, is because they are non-randomized, the decision to give statins to a patient with hepatitis C may or not may depend on factors that have a lot to do with severity of liver disease," Dr. El-Serag told Reuters Health.

"Do not avoid statins because of underlying liver disease, because you may help the statin-related indication, such as cholesterol and heart disease, but you may still get additional benefit for reducing the risk of liver cancer," he advised.

Still, Dr. El-Serag said, "I would stop shy of recommending it just to (prevent) liver cancer."

SOURCE: http://bit.ly/Ze6jf8

J Clin Oncol 2013.