Statins are associated with increased risk of squamous cell carcinoma of the skin: a whole-population study from Iceland.

• Published in: Archives of Dermatological Research
• Main Authors: Adalsteinsson, Jonas A, Muzumdar, Sonal, Waldman, Reid, Hu, Chaoran, Wu, Rong, Ratner, Désirée, Feng, Hao, Ungar, Jonathan, Silverberg, Jonathan I, Olafsdottir, Gudridur H, Kristjansson, Arni Kjalar, Tryggvadottir, Laufey, Jonasson, Jon Gunnlaugur
• Other Authors: 1University of Connecticut Department of Dermatology, 21 South Road, Farmington, CT, 06030, USA. [e-mail]. 2Faculty of Medicine, University of Iceland, Saemundargata 2, 101, Reykjavík, Iceland. [e-mail]. 3University of Connecticut Department of Dermatology, 21 South Road, Farmington, CT, 06030, USA. 4Connecticut Convergence Institute for Translation in Regenerative Engineering, 195 Farmington Avenue, Farmington, CT, 06030, USA. 5Department of Dermatology, NYU Langone Health, New York, NY, 10016, USA. 6Mount Sinai Department of Dermatology, One Gustave L. Levy Place, New York, NY, 10029, USA. 7The George Washington University School of Medicine and Health Sciences, Washington, DC, USA. 8Icelandic Cancer Registry, Skogarhlid 8, 105, Reykjavík, Iceland. 9Department of Pathology, Landspitali National-University Hospital, Hringbraut, 101, Reykjavik, Iceland. 10Faculty of Medicine, University of Iceland, Saemundargata 2, 101, Reykjavík, Iceland. #Contributed equally.
• Format: Article in Journal/Newspaper
• Language: English
• Published: Springer 2021
• Subjects: Atorvastatin; Basal cell carcinoma; Nonmelanoma skin cancer; Simvastatin; Squamous cell carcinoma; Statins; Flöguþekjukrabbamein; Húðkrabbamein; Carcinoma; Squamous Cell; Iceland
• Online Access: http://hdl.handle.net/2336/621774; https://doi.org/10.1007/s00403-021-02227-w

To access publisher's full text version of this article click on the hyperlink below Statins have been associated with an increased risk of keratinocyte carcinoma but data are limited and conflicting. Statins are hypothesized to contribute to KC through immunomodulation. A whole-population case-control study of the Icelandic population was conducted using the Icelandic Cancer Registry and Icelandic Prescription Medicine Register. These are high-quality registers which include all cancer diagnoses, as well as every prescription in the country. Cases included all first-time histologically confirmed diagnoses of (BCC), in situ squamous cell carcinoma (SCCis) and invasive SCC between 2003 and 2017. Each case was paired with 10 age- and sex-matched controls. Multivariate conditional logistic regression analysis was performed. Four thousand seven hundred patients with BCC, 1167 patients with SCCis and 1013 patients with invasive SCC were identified and paired with 47,292, 11,961 and 10,367 controls, respectively. Overall statin use was associated with an increased risk of invasive SCC and SCCis but not BCC (adjusted OR [95% CI]: 1.29 [1.11-1.50]; 1.43 [1.24-1.64]; 1.03 [0.95-1.12], respectively). Subgroup analysis demonstrated that statins were significantly associated with invasive SCC and SCCis in patients over 60, but not in those under 60. Atorvastatin was only associated with an increased risk of SCCis; whereas, simvastatin was associated with an increased risk of both invasive SCC and SCCis. This whole-population study of Iceland demonstrates that statin exposure is associated with increased risk of SCC, but not BCC, in a low UV environment. The reasons are unclear, but our results may suggest that individuals receiving atorvastatin and simvastatin have differing levels of baseline keratinocyte cancer risk or that properties of a statin other than 'statin intensity' affect association with SCC. Keywords: Atorvastatin; Basal cell carcinoma; Nonmelanoma skin cancer; Simvastatin; Squamous cell carcinoma; Statins.