Could statins lower risk of ovarian cancer?

In the UK, ovarian cancer is the sixth most common cancer in females*. A new study has found evidence to suggest that statins could lower the risk of women developing ovarian cancer. The research led by the University of Bristol, and funded by Cancer Research UK, is published today [18 February] in JAMA.

Some previous observational epidemiological studies have suggested a link between statin use, a commonly prescribed medicine to reduce cholesterol, and a lower risk of ovarian cancer. However, the studies have been unclear whether statin use itself was driving this association or whether some other difference between statin users and non-users was lowering the risk of ovarian cancer.

Using a genetic epidemiological approach, known as Mendelian randomization, which can more reliably evaluate causal relationships between characteristics, such as drug targets, molecular traits, behaviours and health outcomes, the researchers found evidence to suggest that statins may lower the risk of ovarian cancer.

The findings were shown in both women who had no known family history of ovarian cancer and in those with mutations in BRCA1 or BRCA2 genes that put them at a higher lifetime risk of the disease.

In total, the study included 22,406 women with ovarian cancer and 40,941 women without ovarian cancer (controls). The study also assessed the relationship of statins with ovarian cancer risk in 3,887 women with ovarian cancer, who were also carriers of BRCA1/2 mutations, and compared these with 27,561 women without ovarian cancer who were also carriers of BRCA1/2 mutations.

James Yarmolinsky, Integrative Cancer Epidemiology Programme Research Associate in the Bristol Medical School: Population Health Sciences (PHS), who led the research, said: "While previous findings have suggested a correlation between statin use and a lower risk of ovarian cancer, these are the first findings to suggest that this relationship may be causal.

"If our findings were to be confirmed in a randomised controlled trial, statin use could be a viable non-surgical approach for reducing the risk of women developing ovarian cancer in the future, including women who are carriers of BRCA1/2 mutations and are thus at increased risk of developing ovarian cancer over their lifetime."

The research team's findings suggest that the use of statins, which are commonly prescribed, inexpensive, and safe, might be a new method for cancer prevention, as there are very few proven non-surgical approaches available to lower the risk of ovarian cancer.

Richard Martin, Professor of Clinical Epidemiology in the Bristol Medical School: (PHS), added: "While the research suggests a potential protective role in ovarian cancer risk, these findings alone cannot establish whether taking these drugs would definitely lower cancer risk.

"The potential protective effects of taking these drugs would need to be shown in a randomised controlled trial first before statin therapy could be encouraged as a method for reducing ovarian cancer risk."

The next steps include testing the study's findings in independent datasets using alternative epidemiological approaches along with unpicking the potential biological mechanisms underlying this association.

Paper

'Association between genetically proxied inhibition of HMG-CoA reductase and epithelial ovarian cancer' by James Yarmolinsky, Caroline J Bull, Emma E Vincent, Jamie Robinson, Axel Walther, George Davey Smith, Sarah J Lewis, Caroline L Relton, Richard M Martin in JAMA

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