Table 5.
Age- and Multivariable-Adjusted Relative Risks of Skin Cancer Among Women and Men with a History of High Cholesterol, According to Type of Statin use, Nurses’ Health Study (NHS, 2004–2010) and Health Professionals Follow-Up Study (HPFS, 2004–2010)
| No. of Cases | Person-Years | Age-Adjusted RR | 95% CI | Multivariable-Adjusted RR* | 95% CI | |
|---|---|---|---|---|---|---|
| Basal cell carcinoma | ||||||
| NHS | ||||||
| No statin use | 1583 | 87,512 | 1.00 | Reference | 1.00 | Reference |
| Lovastatin use | 117 | 5,797 | 1.06 | 0.88, 1.28 | 1.04 | 0.86, 1.26 |
| Simvastatin use | 394 | 17,803 | 1.02 | 0.91, 1.14 | 1.03 | 0.92, 1.16 |
| Rosuvastatin use | 198 | 10,288 | 1.07 | 0.92, 1.24 | 1.08 | 0.93, 1.25 |
| Pravastatin use | 337 | 22,202 | 0.92 | 0.82, 1.04 | 0.94 | 0.83, 1.06 |
| Atorvastatin use | 576 | 28,877 | 1.02 | 0.92, 1.12 | 1.03 | 0.94, 1.14 |
| HPFS | ||||||
| No statin use | 360 | 19,484 | 1.00 | Reference | 1.00 | Reference |
| Lovastatin use | 29 | 1,406 | 1.06 | 0.72, 1.55 | 1.01 | 0.69, 1.47 |
| Simvastatin use | 197 | 8,637 | 1.15 | 0.97, 1.37 | 1.15 | 0.96, 1.37 |
| Rosuvastatin use | 19 | 1,439 | 0.75 | 0.47, 1.20 | 0.75 | 0.47, 1.20 |
| Pravastatin use | 25 | 2,124 | 0.62 | 0.41, 0.93 | 0.62 | 0.41, 0.93 |
| Atorvastatin use | 291 | 14,261 | 1.11 | 0.95, 1.30 | 1.11 | 0.95, 1.30 |
| Pooled† | ||||||
| No statin use | 1,943 | 106,996 | 1.00 | Reference | 1.00 | Reference |
| Lovastatin use | 146 | 7,203 | 1.06 | 0.89, 1.25 | 1.03 | 0.87, 1.22 |
| Simvastatin use | 591 | 26,440 | 1.10 | 1.00, 1.20 | 1.09 | 1.00, 1.20 |
| Rosuvastatin use | 217 | 11,727 | 1.00 | 0.87, 1.15 | 1.01 | 0.88, 1.16 |
| Pravastatin use | 362 | 24,325 | 0.86 | 0.77, 0.96 | 0.88 | 0.79, 0.99 |
| Atorvastatin use | 867 | 43,138 | 1.07 | 0.99, 1.16 | 1.07 | 0.99, 1.16 |
|
| ||||||
| Squamous cell carcinoma | ||||||
| NHS | ||||||
| No statin use | 162 | 88,126 | 1.00 | Reference | 1.00 | Reference |
| Lovastatin use | 21 | 5,825 | 1.87 | 1.18, 2.95 | 1.82 | 1.15, 2.88 |
| Simvastatin use | 27 | 17,919 | 0.88 | 0.58, 1.33 | 0.91 | 0.60, 1.37 |
| Rosuvastatin use | 23 | 10,362 | 1.13 | 0.73, 1.77 | 1.17 | 0.75, 1.83 |
| Pravastatin use | 45 | 22,343 | 0.99 | 0.70, 1.40 | 1.03 | 0.73, 1.45 |
| Atorvastatin use | 44 | 29,080 | 0.86 | 0.61, 1.21 | 0.89 | 0.63, 1.26 |
| HPFS | ||||||
| No statin use | 56 | 19,795 | 1.00 | Reference | 1.00 | Reference |
| Lovastatin use | 7 | 1,432 | 1.52 | 0.68, 3.39 | 1.55 | 0.70, 3.44 |
| Simvastatin use | 27 | 8,789 | 1.01 | 0.63, 1.60 | 1.02 | 0.64, 1.62 |
| Rosuvastatin use | 4 | 1,452 | 0.86 | 0.31, 2.39 | 0.91 | 0.33, 2.52 |
| Pravastatin use | 11 | 2,141 | 1.85 | 0.97, 3.53 | 1.78 | 0.92, 3.42 |
| Atorvastatin use | 52 | 14,512 | 1.29 | 0.88, 1.89 | 1.31 | 0.89, 1.92 |
| Pooled† | ||||||
| No statin use | 218 | 107,920 | 1.00 | Reference | 1.00 | Reference |
| Lovastatin use | 28 | 7,257 | 1.83 | 1.23, 2.71 | 1.77 | 1.20, 2.63 |
| Simvastatin use | 54 | 26,708 | 0.95 | 0.75, 1.37 | 0.94 | 0.69, 1.27 |
| Rosuvastatin use | 27 | 11,814 | 1.05 | 0.71, 1.60 | 1.15 | 0.77, 1.73 |
| Pravastatin use | 56 | 24,484 | 1.07 | 0.78, 1.42 | 1.16 | 0.85, 1.56 |
| Atorvastatin use | 96 | 43,592 | 1.11 | 0.88, 1.43 | 1.04 | 0.81, 1.33 |
|
| ||||||
| Melanoma | ||||||
| NHS | ||||||
| No statin use | 40 | 88,241 | 1.00 | Reference | 1.00 | Reference |
| Lovastatin use | 3 | 5,839 | 1.11 | 0.34, 3.61 | 1.10 | 0.34, 3.59 |
| Simvastatin use | 6 | 17,939 | 0.70 | 0.29, 1.68 | 0.73 | 0.30, 1.74 |
| Rosuvastatin use | 7 | 10,376 | 1.41 | 0.62, 3.20 | 1.46 | 0.64, 3.33 |
| Pravastatin use | 15 | 22,364 | 1.41 | 0.76, 2.62 | 1.39 | 0.74, 2.60 |
| Atorvastatin use | 12 | 29,105 | 0.96 | 0.50, 1.87 | 0.96 | 0.49, 1.88 |
| HPFS | ||||||
| No statin use | 13 | 19,835 | 1.00 | Reference | 1.00 | Reference |
| Lovastatin use | 2 | 1,437 | 2.01 | 0.44, 9.15 | 1.88 | 0.38, 9.37 |
| Simvastatin use | 6 | 8,805 | 1.05 | 0.40, 2.80 | 1.05 | 0.38, 2.89 |
| Rosuvastatin use | 0 | 1,458 | 0.00 | 0.00, 0.00 | 0.00 | 0.00, 0.00 |
| Pravastatin use | 2 | 2,145 | 1.50 | 0.33, 6.73 | 1.53 | 0.32, 7.24 |
| Atorvastatin use | 7 | 14,545 | 0.88 | 0.35, 2.22 | 0.76 | 0.29, 1.99 |
| Pooled† | ||||||
| No statin use | 53 | 108,077 | 1.00 | Reference | 1.00 | Reference |
| Lovastatin use | 5 | 7,276 | 1.32 | 0.53, 3.32 | 1.30 | 0.51, 3.30 |
| Simvastatin use | 12 | 26,744 | 0.87 | 0.46, 1.64 | 0.87 | 0.46, 1.64 |
| Rosuvastatin use | 7 | 11,834 | 1.20 | 0.54, 2.66 | 1.22 | 0.54, 2.71 |
| Pravastatin use | 17 | 24,510 | 1.37 | 0.78, 2.41 | 1.39 | 0.79, 2.45 |
| Atorvastatin use | 19 | 43,650 | 0.93 | 0.55, 1.58 | 0.90 | 0.52, 1.54 |
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.