Evaluation of the relationship between previous statin use and thyroid cancer using Korean National Health Insurance Service-Health Screening Cohort data

So Young Kim,Jee Hye Wee,Bumjung Park,Dae Myoung Yoo,Chanyang Min,Young Shin Song,Chang Myeon Song,Chang-Ho Lee,Hyo Geun Choi

doi:10.1038/s41598-021-87297-6

Abstract

The association of thyroid cancer with statin use is controversial. This study aimed to investigate the association of previous statin use with thyroid cancer in the ≥ 40-year-old population in the Korean National Health Insurance Service-Health Screening Cohort. The 5501 patients in the thyroid cancer group were matched with the 22,004 patients in the non-thyroid cancer group for age, sex, income, and region of residence. Previous statin use during the 2 years before the diagnosis of thyroid cancer was examined. The odds ratios (ORs) with 95% confidence intervals (CIs) of previous statin use for thyroid cancer were estimated using conditional logistic regression analyses. Additionally, subgroup analyses were conducted. The thyroid cancer group showed more days of previous statin use than the non-thyroid cancer group (72.3, standard deviation [SD] = 181.2 days vs. 64.3, SD = 174.4 days, P = 0.003). Although the odds of previous statin use for thyroid cancer were high in the crude model (OR = 1.10, 95% CI 1.04–1.17, P = 0.002), they were low in the fully adjusted model (OR = 0.89, 95% CI 0.82–0.95, P = 0.001). According to age and sex subgroups, the younger (< 60 years old) male group showed lower odds for thyroid cancer according to previous statin use (adjusted OR = 0.70, 95% CI 0.55–0.88, P = 0.003), but this finding was not observed in other subgroups of older men or in any groups of women. Thyroid cancer was negatively associated with statin use in the previous 2 years in the adjusted model.

Highlights

Statins are lipid-lowering agents that act as a 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) r eductase[1]
The thyroid cancer group showed higher odds for previous statin use in the crude model (OR = 1.10, 95% confidence intervals (CIs) 1.04–1.17, P = 0.002, Table 2)
The odds of previous statin use for thyroid cancer were low in model 1 and in model 2

Summary

Introduction

Statins are lipid-lowering agents that act as a 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) r eductase[1]. As with other types of tumors, tumor cell cycle arrest at the G1 phase and apoptosis promotion have been suggested as possible molecular mechanisms for the anticancer effects of statins in thyroid c ancer[16,17,18]. A previous case–control study in Taiwan demonstrated that statin medication was linked with an increased rate of thyroid cancer[21]. If previous stain use might be able to contribute to decreasing the high prevalence of thyroid cancer, the prescription of statins could be a way to prevent thyroid cancer. To minimize potential confounding effects of past medical histories, obesity, smoking habit, and alcohol drinking, these variables were adjusted in the analysis of the relationship between previous statin use and thyroid cancer. Because of the sex differences in thyroid cancer, subgroup analyses were implemented in accordance with age and sex, and other variables were specified for the subgroup analyses

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Conclusion