March 8, 2009

Statins May Reduce PSA Levels


Statins May Reduce PSA Levels

The use of cholesterol-lowering drugs known as statins is associated with a decline in prostate specific antigen (PSA) levels, according to the results of a study published in the November 5, 2008 issue of the Journal of the National Cancer Institute.[1]

The prostate is a walnut-size gland located between the bladder and rectum in men and is responsible for the formation of a portion of semen. Prostate cancer is common among men in the United States, and testing for the disease after the age of 50 is becoming a routine practice.

Prostate specific antigen, or PSA, is a protein that is normally shed by the prostate into the bloodstream. The PSA test measures the levels of PSA in the bloodstream, and elevated PSA levels can indicate the presence of prostate cancer, or other non-cancerous (benign) prostate conditions. Although the PSA test is a routine screening procedure and may help to diagnose prostate cancer at an earlier stage, there is still no evidence that PSA screening actually reduces prostate cancer mortality.

Statins are cholesterol-lowering drugs and are the most commonly prescribed class of prescription drugs in the U.S. These drugs have relatively few side effects and have been credited with reducing LDL (”bad”) cholesterol levels and improving cardiovascular health. Furthermore, some evidence has linked statins with the prevention of cancer, including a Finnish study that reported a 50-65% reduction in prostate cancer risk among statin users versus non-users.[2]

In the current study, researchers from Duke University examined the medical wp_posts of 1,214 men without prostate cancer who were prescribed statins between 1990 and 2006. They compared PSA levels taken up to one year prior to the initiation of statin therapy with the PSA levels measured within two years after initiation of statin use.

The results indicated that PSA levels declined by a statistically significant extent after initiation of statin treatment. Overall, there was a 4.1% average PSA decline and a 27.5% average LDL decline. Men with higher initial PSA levels had larger declines after beginning statin therapy than men with low initial PSA levels. Furthermore, the PSA decline appeared to be correlated with the magnitude of LDL decrease. In other words, the more the LDL declined, the more the PSA declined.

While these results are intriguing, the questions left unanswered by this study are whether statins might prevent prostate cancer, treat prostate cancer, or simply affect PSA levels alone. It is imperative to remember that a reduction in PSA does not necessarily correlate with a reduction in prostate cancer risk. By lowering PSA levels, statins could actually complicate prostate cancer detection. Furthermore, it is important to understand the difference between statistical significance and clinical application. Even though a 4.1% drop in the average PSA level might be statistically significant, that does not necessarily make it meaningful in the clinical setting. Research is ongoing to evaluate the relationship between statins and cancer risk.


[1] Hamilton RJ, Goldberg KC, Platz EA. The influence of statin medications on prostate-specific antigen levels. Journal of the National Cancer Institute. 2008;100:1511-1518.

[2] Murtola TJ, Tammela TLJ, Maattanen L. Statins and prostate cancer among men participating in the Finnish Prostate Cancer Screening Trial. American Urological Association Meeting, Anaheim, California; 2007. Abstract 1719.

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