Table 4.
Age- and Multivariable-Adjusted Relative Risks of Skin Cancer Among Women and Men with a History of High Cholesterol, According to Duration of Statin use, Nurses’ Health Study (NHS, 2000–2010) and Health Professionals Follow-Up Study (HPFS, 2000–2010)
| No. of Cases | Person-Years | Age-Adjusted RR | 95% CI | Multivariable-Adjusted RR* | 95% CI | |
|---|---|---|---|---|---|---|
| Basal cell carcinoma | ||||||
| NHS | ||||||
| <1 year statin use | 2,322 | 158,556 | 1.00 | Reference | 1.00 | Reference |
| 1–2 years statin use | 788 | 50,908 | 1.02 | 0.94, 1.11 | 1.05 | 0.96, 1.14 |
| 3–4 years statin use | 658 | 41,587 | 0.99 | 0.91, 1.08 | 1.01 | 0.93, 1.11 |
| 5–6 years statin use | 491 | 26,515 | 1.04 | 0.94, 1.15 | 1.07 | 0.96, 1.18 |
| 7–8 years statin use | 393 | 20,693 | 1.02 | 0.92, 1.14 | 1.05 | 0.94, 1.17 |
| >8 years statin use | 420 | 20,692 | 0.93 | 0.83, 1.03 | 0.95 | 0.85, 1.06 |
| P-trend = 0.86 | ||||||
| HPFS | ||||||
| <1 year statin use | 660 | 39,363 | 1.00 | Reference | 1.00 | Reference |
| 1–2 years statin use | 235 | 13,890 | 0.98 | 0.84, 1.14 | 0.98 | 0.85, 1.14 |
| 3–4 years statin use | 265 | 14,140 | 1.06 | 0.92, 1.23 | 1.07 | 0.93, 1.24 |
| 5–6 years statin use | 191 | 9,473 | 1.12 | 0.95, 1.32 | 1.12 | 0.95, 1.32 |
| 7–8 years statin use | 138 | 7,067 | 1.07 | 0.89, 1.30 | 1.07 | 0.89, 1.30 |
| >8 years statin use | 213 | 9,263 | 1.28 | 1.08, 1.50 | 1.28 | 1.08, 1.50 |
| P-trend = 0.003 | ||||||
| Pooled† | ||||||
| <1 year statin use | 2,982 | 197,918 | 1.00 | Reference | 1.00 | Reference |
| 1–2 years statin use | 1,023 | 64,798 | 1.02 | 0.95, 1.10 | 1.03 | 0.96, 1.11 |
| 3–4 years statin use | 923 | 55,727 | 1.04 | 0.96, 1.12 | 1.05 | 0.97, 1.13 |
| 5–6 years statin use | 682 | 35,989 | 1.09 | 1.00, 1.18 | 1.09 | 1.00, 1.19 |
| 7–8 years statin use | 531 | 27,761 | 1.05 | 0.96, 1.15 | 1.05 | 0.95, 1.15 |
| >8 years statin use | 633 | 29,955 | 1.04 | 0.95, 1.14 | 1.03 | 0.94, 1.13 |
| P-trend = 0.20 | ||||||
|
| ||||||
| Squamous cell carcinoma | ||||||
| NHS | ||||||
| <1 year statin use | 294 | 159,586 | 1.00 | Reference | 1.00 | Reference |
| 1–2 years statin use | 77 | 51,278 | 0.80 | 0.62, 1.02 | 0.85 | 0.66, 1.09 |
| 3–4 years statin use | 85 | 41,849 | 1.04 | 0.82, 1.33 | 1.10 | 0.86, 1.40 |
| 5–6 years statin use | 55 | 26,686 | 1.04 | 0.77, 1.40 | 1.09 | 0.81, 1.47 |
| 7–8 years statin use | 40 | 20,828 | 0.94 | 0.67, 1.32 | 0.96 | 0.69, 1.35 |
| >8 years statin use | 35 | 20,817 | 0.84 | 0.59, 1.21 | 0.86 | 0.60, 1.24 |
| P-trend = 0.89 | ||||||
| HPFS | ||||||
| <1 year statin use | 102 | 39,943 | 1.00 | Reference | 1.00 | Reference |
| 1–2 years statin use | 39 | 14,082 | 1.02 | 0.71, 1.48 | 1.04 | 0.72, 1.51 |
| 3–4 years statin use | 40 | 14,374 | 1.02 | 0.71, 1.48 | 1.07 | 0.74, 1.55 |
| 5–6 years statin use | 50 | 9,636 | 1.83 | 1.28, 2.61 | 1.89 | 1.32, 2.70 |
| 7–8 years statin use | 20 | 7,187 | 0.91 | 0.56, 1.50 | 0.95 | 0.58, 1.56 |
| >8 years statin use | 36 | 9,435 | 1.28 | 0.86, 1.92 | 1.31 | 0.87, 1.96 |
| P-trend = 0.09 | ||||||
| Pooled† | ||||||
| <1 year statin use | 396 | 199,529 | 1.00 | Reference | 1.00 | Reference |
| 1–2 years statin use | 116 | 65,360 | 0.87 | 0.71, 1.07 | 0.90 | 0.73, 1.11 |
| 3–4 years statin use | 125 | 56,224 | 1.07 | 0.87, 1.30 | 1.08 | 0.88, 1.32 |
| 5–6 years statin use | 105 | 36,322 | 1.36 | 1.09, 1.70 | 1.35 | 1.08, 1.68 |
| 7–8 years statin use | 60 | 28,015 | 1.00 | 0.76, 1.31 | 0.97 | 0.73, 1.28 |
| >8 years statin use | 71 | 30,252 | 1.10 | 0.84, 1.43 | 1.04 | 0.79, 1.35 |
| P-trend = 0.28 | ||||||
|
| ||||||
| Melanoma | ||||||
| NHS | ||||||
| <1 year statin use | 68 | 159,792 | 1.00 | Reference | 1.00 | Reference |
| 1–2 years statin use | 25 | 51,315 | 1.13 | 0.71, 1.78 | 1.13 | 0.71, 1.80 |
| 3–4 years statin use | 18 | 41,907 | 0.95 | 0.56, 1.60 | 0.96 | 0.57, 1.62 |
| >4 years statin use | 30 | 68,422 | 0.92 | 0.59, 1.45 | 0.93 | 0.59, 1.47 |
| P-trend = 0.68 | ||||||
| HPFS | ||||||
| <1 year statin use | 26 | 40, 008 | 1.00 | Reference | 1.00 | Reference |
| 1–2 years statin use | 11 | 14,109 | 1.24 | 0.61, 2.53 | 1.22 | 0.60, 2.49 |
| 3–4 years statin use | 6 | 14,397 | 0.67 | 0.27, 1.64 | 0.67 | 0.27, 1.66 |
| >4 years statin use | 18 | 26,326 | 1.11 | 0.58, 2.12 | 1.02 | 0.52, 1.97 |
| P-trend = 0.80 | ||||||
| Pooled† | ||||||
| <1 year statin use | 94 | 199,800 | 1.00 | Reference | 1.00 | Reference |
| 1–2 years statin use | 36 | 65,424 | 1.18 | 0.80, 1.73 | 1.18 | 0.80, 1.74 |
| 3–4 years statin use | 24 | 56,304 | 0.89 | 0.56, 1.40 | 0.89 | 0.56, 1.39 |
| >4 years statin use | 48 | 94,747 | 1.00 | 0.70, 1.44 | 0.97 | 0.67, 1.41 |
| P-trend = 0.68 | ||||||
Adjusted for family history of melanoma (yes vs. no), natural hair color (red, blonde, light brown, dark brown, black), number of arm moles (0, 1–2, 3–9, ≥10), sunburn susceptibility as a child/adolescent (none/some redness, burn, painful burn/blisters), number of lifetime blistering sunburns (0, 1–4, 5–9, ≥10), cumulative UV flux since baseline (quintiles), body mass index (<25.0, 25.0–29.9, 30.0–34.9, ≥35.0 kg/m2), physical activity (quintiles), smoking status (never, past, or current), total energy intake (quintiles), alcohol (0, 0.1–4.9, 5.0–9.9, 10.0–19.9, ≥20.0 g/d), and citrus intake (quintiles). Analyses for women were also adjusted for menopausal status and postmenopausal hormone use.
The multivariate-adjusted hazard ratios from each cohort were combined with meta-analytic methods using random effects model