High cholesterol levels are associated with reduced prostate cancer mortality rates during periods of high but not low statin use in the United States

Objective: Some studies suggest that cholesterol may promote prostate cancer development. High serum cholesterol levels are commonly treated with statins, which have been associated with decreased prostate cancer risks. Statin use has increased in this country during the 1990s while prostate mortality rates have gone down. In this study, we compare high cholesterol levels to prostate cancer mortality rates among states over time periods in which statin use has changed. We hypothesize that prostate cancer risks from high cholesterol may be reduced when statin use is high. Methods: State-specific, high cholesterol levels for white males (2001-2003) were compared with age-adjusted prostate cancer mortality rates for each year from 1992 to 2000. To control for medical care access and socioeconomic status, urbanization, family income, and health insurance status were considered. Results: High cholesterol levels correlate inversely with prostate cancer mortality for: 2000 (R = -0.40, P < 0.01); 1999 (R = -0.37, P < 0.01); and 1998 (R = -0.32, P < 0.05), but there was no significant correlation from 1992 to 1997. Stalin use was 46%, 47%, and 49% in 1998, 1999, and 2000, respectively, and ranged from 7% in 1992 to 42% in 1997. Urbanization correlated at the P < 0.05 level from 1994 to 2000 but family income and health insurance status did not correlate. Conclusions: High cholesterol levels were associated with lower prostate cancer mortality rates when statin use was high, but not low, suggesting that statins reduce prostate cancer mortality risks. (C) 2009 Elsevier Inc. All rights reserved.