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TOPLINE:

A new study confirms a protective effect of statin cholesterol-lowering drugs on liver cancer risk and suggests a similar effect with nonstatin cholesterol absorption inhibitors.

METHODOLOGY:

• Numerous studies have suggested that statins may lower the risk for liver cancer, but whether nonstatin lipid-lowering drugs produce a similar effect has not been sufficiently analyzed.
• Researchers examined associations between five types of nonstatin lipid-lowering drugs (cholesterol absorption inhibitors, bile acid sequestrants, fibrates, niacin, and omega-3 fatty acids) and liver cancer risk overall, type 2 diabetes status, and chronic liver disease status.
• Using data from the UK Clinical Practice Research Datalink, they identified 3719 primary liver cancer cases and 14,876 matched controls.

TAKEAWAY:

• Ever use of cholesterol absorption inhibitors was associated with a reduced risk for liver cancer (odds ratio [OR], 0.69), which was consistent among individuals with diabetes and those with and without chronic liver disease.
• Conversely, ever use of bile acid sequestrants was associated with an increased risk for liver cancer (OR, 5.31), but results of analyses based on diabetes and liver disease status were inconsistent.
• No significant associations were observed for fibrates, niacin, or omega-3 fatty acids.
• Ever and current use of statins were confirmed to have an inverse association with the risk for liver cancer (OR, 0.65 and 0.61, respectively).

IN PRACTICE:

"The current results suggest that use of cholesterol absorption inhibitors may be associated with reduced risk of liver cancer," the authors concluded. "Future studies are needed to confirm the results and clarify the association of all non-statin cholesterol-lowering medications and liver cancer."

SOURCE:

The study, with first author Shahriar A. Zamani, PhD, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland, was published online in Cancer.

LIMITATIONS:

Liver cancer diagnoses were not verified against cancer registry records, potentially leading to misclassification. Incomplete reporting of chronic hepatitis B and C infections and alcohol-related disorders could have affected the results.

DISCLOSURES:

The study was funded by the National Institutes of Health Intramural Research Program. The authors declared no conflicts of interest.