Higher cholesterol levels, not statin use, are associated with a lower risk of hepatocellular carcinoma

Br J Cancer. 2020 Mar;122(5):630-633. doi: 10.1038/s41416-019-0691-3. Epub 2019 Dec 20.

Abstract

We aimed to examine whether statin users have a lower risk of hepatocellular carcinoma (HCC) after careful consideration of prevalent statin use and cholesterol levels. During a mean prospective follow-up of 8.4 years in 400,318 Koreans, 1686 individuals were diagnosed with HCC. When prevalent users were included, HCC risk was reduced by >50% in statin users, regardless of adjustment for total cholesterol (TC). When prevalent users were excluded, new users who initiated statins within 6 months after baseline had a 40% lower risk of HCC (hazard ratio [HR] = 0.59) in a TC-unadjusted analysis. However, this relationship disappeared (HR = 1.16, 95% CI = 0.80-1.69) after adjusting for TC levels measured within 6 months before statin initiation. TC levels had strong inverse associations with HCC in each model. High cholesterol levels at statin initiation, not statin use, were associated with reduced risk of HCC. Our study suggests no protective effect of statins against HCC.

MeSH terms

  • Carcinoma, Hepatocellular / blood*
  • Carcinoma, Hepatocellular / epidemiology*
  • Cholesterol / blood*
  • Cohort Studies
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / administration & dosage*
  • Incidence
  • Liver Neoplasms / blood*
  • Liver Neoplasms / epidemiology*
  • Male
  • Proportional Hazards Models
  • Republic of Korea / epidemiology

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Cholesterol