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Table 4 Sensitivity analysis of association between statin use and breast cancer-specific and all-cause mortality in patients with breast cancer

From: Statin use and breast cancer survival: a nationwide cohort study in Scotland

 

Medication user

Medication non-user

Age-adjusted HR (95 % CI)

P

Adjusted HR (95 % CI)

P

P interaction

Cancer\all mortality

Patients

Person years

Cancer\all mortality

Patients

Person years

Cancer-specific mortality

 Subgroup analyses: Statin users versus non-usersa

  Stage 1–2

111

3,185

8,085

310

8,467

24,768

0.86 (0.69,1.08)

0.21

0.91 (0.68,1.21)

0.51

 

  Stage 1–3

209

3,671

9,224

555

10,793

28,147

0.91 (0.77,1.08)

0.29

1.02 (0.83,1.26)

0.85

  Diagnosed 2009–2010

207

2,187

6,820

569

5,211

19,746

0.79 (0.67,0.93)

0.06

0.77 (0.60,0.98)

0.04

0.08

  Diagnosed 2011–2012

128

2,046

3,601

286

5,696

11,106

1.03 (0.83,1.28)

0.77

1.35 (0.98,1.85)

0.06

  Estrogen receptor positive

243

3,655

9,079

552

8,995

25,600

0.88 (0.75,1.03)

0.11

0.92 (0.72,1.16)

0.48

 

  Estrogen receptor negative

87

514

1197

279

1710

4705

0.95 (0.73,1.23)

0.69

1.06 (0.76,1.48)

0.72

 

  Hormone receptors availableb

212

2610

6193

550

6918

18682

0.89 (0.75,1.05)

0.18

0.98 (0.77,1.25)

0.89

 

  Using 1 year lagc

320

4067

9695

870

11073

31578

0.91 (0.80,1.04)

0.18

1.00 (0.78,1.28)

0.99

 

 Adjusted for competing risk of deathd

  Statin

335

4,233

10,421

855

10,907

30,852

0.88 (0.78, 1.00)

0.07

0.98 (0.81, 1.19)

0.88

 

  Simvastatin

224

3,025

7,428

966

12,115

33,845

0.83 (0.72, 0.97)

0.02

0.91 (0.75, 1.12)

0.38

 

 Use in first year after diagnosise

  Statin user versus non-user

318

3,624

9,555

872

11,516

31,718

0.89 (0.78,1.02)

0.10

0.99 (0.82,1.21)

0.95

 

  Simvastatin user versus non-user

210

2,470

6,569

980

12,670

34,704

0.86 (0.74,1.00)

0.05

0.95 (0.78,1.17)

0.65

 

All-cause mortality

 Subgroup analyses: Statin users versus non-usersa

  Stage 1–2

297

3,185

8,085

554

8,467

24,768

0.99 (0.85,1.14)

0.87

0.89 (0.74,1.06)

0.20

 

  Stage 1–3

437

3,671

9,224

859

10,793

28,147

0.98 (0.87,1.10)

0.72

0.91 (0.78,1.06)

0.24

  Diagnosed 2009–2010

456

2,187

6,820

871

5,211

19,746

0.94 (0.83,1.05)

0.26

0.79 (0.66,0.94)

0.01

0.38

  Diagnosed 2011–2012

228

2,046

3,601

452

5,696

11,106

0.97 (0.82,1.14)

0.71

1.02 (0.79,1.30)

0.89

  Estrogen receptor positive

549

3,655

9,079

946

8,995

25,600

0.98 (0.88,1.09)

0.70

0.85 (0.72,1.01)

0.06

 

  Estrogen receptor negative

119

514

1197

324

1710

4705

0.99 (0.79,1.24)

0.92

1.00 (0.74,1.34)

0.98

 

  Hormone receptors availableb (and adjusted for)

400

2610

6193

806

6918

18682

0.95 (0.84,1.08)

0.43

0.89 (0.74,1.07)

0.23

 

  Using 1 year lagc

648

4067

9695

1359

11073

31578

0.97 (0.88,1.07)

0.54

0.91 (0.75,1.10)

0.33

 

  Cardiovascular deaths

142

4233

10421

132

10907

30852

3.21 (2.53,4.06)

<0.001

1.07 (0.73,1.55)

0.74

 

  Non-cardiovascular deaths

542

4233

10421

1191

10907

30852

1.36 (1.23,1.50)

<0.001

0.86 (0.74,1.00)

0.06

 

 Use in first year after diagnosise

  Statin user versus non-user

649

3,624

9,555

1,358

11,516

31,718

0.97 (0.88,1.07)

0.55

0.91 (0.79,1.06)

0.23

 

  Simvastatin user versus non-user

445

2,470

6,569

1,562

12,670

34,704

0.96 (0.86,1.07)

0.47

0.89 (0.77,1.04)

0.15

 
  1. aBased upon main time varying covariate analysis adjusted model contains age, year of diagnosis, socioeconomic status, stage, grade, cancer treatment within 6 months (radiotherapy, chemotherapy, surgery), comorbidities (prior to diagnosis, including acute myocardial infarction, congestive heart disease, peripheral vascular disease, cerebral vascular accident, pulmonary disease, peptic ulcer, liver disease, diabetes, renal disease) hormone replacement therapy use (in year prior to diagnosis) and other prescription medication use (tamoxifen, aromatase inhibitor, low-dose aspirin, and metformin as time varying covariates)
  2. bModel contains all variables in a along with estrogen, progesterone and HER2 receptor status, where available
  3. cStatin use modelled as a time varying covariate with a 1 year lag. Model contains all variables in 1 with prescription medication use all modelled with a 1 year lag (tamoxifen, aromatase inhibitor, low-dose aspirin use and metformin)
  4. dReported estimates are subdistribution hazard ratios and 95 % CIs
  5. eModel contains age, year of diagnosis, deprivation, stage, grade, cancer treatment within 6 months (radiotherapy, chemotherapy, surgery), comorbidities (prior to diagnosis, including acute myocardial infarction, congestive heart disease, peripheral vascular disease, cerebral vascular accident, pulmonary disease, peptic ulcer, liver disease, diabetes, renal disease) hormone replacement therapy use (in year prior to diagnosis) and other prescription medication use in the first year after diagnosis (tamoxifen, aromatase inhibitor, low-dose aspirin use and metformin)
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BMC Cancer

ISSN: 1471-2407

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