According to results from a population-based cohort study published in the Journal of Thoracic Oncology, combined usage of aspirin, statins, and metformin may be correlated with decreases in lung-cancer incidence and mortality. Previous studies have demonstrated varied results on whether aspirin, metformin, or statins have a protective effect against cancers.
In this study, Kang et al attempted to explore the associations of aspirin, metformin, and statins with lung-cancer risk and mortality utilizing population-based, nationwide cohort data. In a recent press release, one of the lead authors, Dr. Shin, stated, “To our knowledge, no study has evaluated aspirin, statins, and metformin use and their combined impact on lung cancer incidence and mortality.”
The study involved 732,199 subjects. Exposure to medication was measured as cumulative duration of use or cumulative defined daily dose (cDDD) per 2 years. To address the combined associations of these drugs with lung-cancer risk and mortality, the researchers categorized the cohort into eight groups, based on exposure to aspirin, statins, and metformin. Medication exposure was utilized as a time-dependent variable in Cox analysis. Numerous models were employed to adapt for covariates such as age, gender, income, body mass index, smoking status, and alcohol use.
Kang et al indicated that the numbers of ever-users of aspirin and statins were 66,024 (9.0%) and 37,031 (5.1%), respectively. Type 2 diabetes was present in 6.3% of patients (46,205), of whom 55.8% were ever-users of metformin. During follow-up, 5,990 lung cancers were diagnosed, and 5,938 patients died from lung cancer. The study noted that there was no link between ever-use of aspirin and prevalence of lung cancer or lung cancer–related mortality. Cumulative use of aspirin, however, was associated with lung cancer–related mortality (adjusted hazard ratio [aHR], 0.87; 95% CI, 0.78-0.97; P = .073).
Ever-use and cumulative use of statins was not associated with lung cancer incidence. High levels of cumulative statin use were associated with a decrease in lung cancer–related mortality (aHR, 0.77; 95% CI, 0.59-0.99; P =.004). Among type 2 diabetes patients, ever-use of metformin was significantly linked with a diminished prevalence of lung cancer compared with patients without diabetes (aHR, 0.89; 95% CI, 0.81-0.98). There was also a correlation between cumulative metformin use and decreased lung cancer incidence (aHR, 0.44; 95% CI, 0.29-0.66) but not mortality (aHR, 0.76; 95% CI, 0.54-1.09).
There was a greater correlation between metformin and lung cancer mortality among nonsmokers and women compared with the entire cohort. Key findings from the study revealed that combined use of aspirin, statins, and metformin was associated with decreased lung cancer incidence (aHR = 0.83, 95% CI, 0.69-0.99) and mortality (aHR = 0.83, 95% CI, 0.70-0.99) compared with not using the agents.
Additionally, other key findings were that metformin use had a protective association with lung cancer incidence and mortality in a dose-response fashion, and lung cancer mortality was dose-dependently reduced with the use of aspirin and statins.
The authors concluded, “The use of aspirin, metformin, and statins had independent protective associations with lung cancer mortality, and metformin had inverse association with lung cancer risk. Further studies are necessary to develop clinically applicable anticancer strategies of these drugs for the reduction of lung cancer and related mortality.”
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