Population-based study of effect ot statins on mortality among long-term survivors of nasopharyngeal carcinoma

A territory-wide cohort study in Hong Kong investigated the relationship between statin use and mortality among 5-year survivor of nasopharyngeal carcinoma (NPC). Patients who survived five years after diagnosis of non-metastatic NPC between 1997 and 2015 were included. Patients were divided into statin users and statin non-users, using IPTW to balance confounding factors. A total of 2439 statin users and 5433 statin non-users were included in the final analysis. The 10-year, 15-year and 20-year survival probabilies of statin users compared to non-users were 89.1% versus 71.8%, 77.2% versus 55.1%, and 59.2% versus 42.4%, respectively (HR 0.46; p<0.001). After adjusting for immortal time bias, the HR for overall survival was 0.71 (p<0.001). Statin use was associated with reduced risk of death due to secondary malignancy (HR 0.51; p=0.002), cardiovascular disease (HR 0.64; p=0.002), and pulmonary disease (HR 0.64; p=0.011). In exploratory analyses, patients who received second- or third-generation statins were at lower risk of mortality (HR 0.66 and HR 0.41, respectively), although this finding requires further validation. The authors conclude that these results suggest that statin use is associated with reduced mortality in long-term NPC survivors.