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Les statines pourrait reduire de 50%
le risque de cancer du poumon

Juin 2007

Revoir également :
----- Statines , des effets collatéraux intéressants [Lire]
----- Les statines en prévention des cancers |Lire]


Le cancer du poumon est un des cancers les plus fréquents et probablement le plus meurtrier. Le tabagisme est le facteur de risque majeur, sur lequel une intervention est possible (arrêt). Les statines (inhibiteurs de la 3-OH-MetCoA réductase) sont largement utilisées dans le traitement des hypercholestérolémies, et dans des protocoles de prévention des accidents cardiovasculaires. Des études épidémiologiques ont montré leur effet bénéfique sur la survenue de cancers. BR>
Selon l'étude de Khurana V et coo, en fonction de la durée d'utilisation des statines, l'effet protecteur existait pour une prise supérieure à 6 mois. L'Odds ratio (OR) diminuait avec la durée de la prise : prise depuis 1 à 2 ans : OR=0,7, et prise depuis plus de 4 ans : OR=0,23. Cet effet protecteur se maintient chez les fumeurs, et quels que soient les autres désordres métaboliques associés.

Les statines sont associées à une réduction de 48% du risque de cancer bronchique.

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Statins reduce the incidence of lung cancer
a study of half a million US veterans

Khurana V et coll. : "Statins Reduce the Risk of Lung Cancer in Humans: A Large Case-Control Study of US Veterans." Chest 2007; 131 : 1282-1288
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Background:
Statins (HMG CoA reductase inhibitors) are commonly used cholesterol-lowering agents that are noted to suppress tumor growth in several animal models, however clinical data for a chemoprotective role of statins in lung cancer is lacking. We investigated the effect of statins on the development of lung cancer in the US veteran population.

Methods:
The VISN 16 database, which contains clinical and demographic information about all veterans (>1.4 million patients) cared for in the South Central VA Health Care Network, was queried from Oct 1998 to June 2004. Retrospective case control design was used. Patients were included in the statin users group if they were using statins prior to the diagnosis of lung cancer but the dose, duration and type of statin used was not factored into the analysis. Statistical analysis was performed using SAS software version 9.0 (Chicago, IL).
Multiple logistic regression analysis was used with calculation of odds ratios and 95% confidence intervals. The data was adjusted for age, gender, smoking and alcohol use.

Results:
A total of 484,226 patients were studied. The mean age was 61.2 (SD+/-15.1) years and 91.7% were men, 164,645 (34%) were using statins. Lung cancer (ICD code of 162) was seen in 7280 (1.5%); 1994 (1.2%) statin users and 5286 (1.7%) statin non-users. Statin users were less likely to develop lung cancer (Odds ratio 0.52: 95% CI 0.49-0.55). The data was controlled for age (OR 1.038, 95% CI for OR 1.036-1.039, p=<0.0001), gender (OR 0.42, 95% CI for OR 0.36-0.49, p=<0.0001), smoking (OR 1.80, 95% CI for OR 1.66-1.95, p=<0.0001), and alcohol use (OR 1.13, 95% CI for OR 1.08-1.19, p=<0.001). All these were highly significant covariates.

Conclusions:
Statins are associated with a 48% risk reduction of lung cancer after controlling for age, gender, smoking and alcohol use. An internal consistency of the database is reflected by an increased risk associated with documented risk factors.
Our data should be evaluated with caution, given the limitations of the population, the database and the fact that this is a case control study.
Some factors known to increase the risk of lung cancer like asbestos exposure were not incorporated into the study.

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