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

Sang-Wook Yi1, Se Hwa Kim2, Ki Jun Han2,3

  • 1Department of Preventive Medicine and Public Health, Catholic Kwandong University College of Medicine, Gangneung, 25601, Republic of Korea. flyhigh@cku.ac.kr.

British Journal of Cancer
|December 21, 2019
PubMed

Insights

Statin use did not show a protective effect against liver cancer (hepatocellular carcinoma). High cholesterol levels, not statin use, were linked to a reduced risk of developing this cancer.

Area of Science:

  • Hepatology
  • Cardiovascular Research
  • Oncology

Background:

  • Hepatocellular carcinoma (HCC) is a significant global health concern.
  • Statins are widely used to lower cholesterol but their role in HCC prevention is debated.
  • Previous studies have yielded conflicting results regarding statins and HCC risk.

Purpose of the Study:

  • To investigate the association between statin use and hepatocellular carcinoma (HCC) risk.
  • To clarify the influence of prevalent statin use and cholesterol levels on this association.
  • To determine if statins offer a protective effect against HCC development.

Main Methods:

  • A large-scale prospective cohort study involving 400,318 Korean individuals.
  • Mean follow-up period of 8.4 years with 1686 incident HCC cases.
  • Analysis considered both prevalent and new statin users, with and without adjustment for total cholesterol (TC).

Main Results:

  • Including prevalent users, statin use was associated with >50% HCC risk reduction, irrespective of TC.
  • Excluding prevalent users, new statin users showed a 40% lower HCC risk (HR=0.59) before TC adjustment.
  • This association disappeared after adjusting for TC (HR=1.16), indicating TC levels, not statin use, were linked to reduced HCC risk.

Conclusions:

  • The study suggests that statins do not have a protective effect against hepatocellular carcinoma.
  • High cholesterol levels at the time of statin initiation, rather than statin use itself, appear associated with a reduced HCC risk.
  • Further research is needed to fully elucidate the complex relationship between lipid metabolism, statin therapy, and HCC pathogenesis.

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