| |
Statin initiators
|
Number of eventsa
|
Person-Years of Follow-Up (hundreds)
|
Crude Rate (per 100 Person-Years)
|
Unadjusted HRb
|
p-value
|
Adjusted HRc
|
p-value
|
|---|
|
n
|
%
|
|---|
|
Cancer status (binary)
|
|
Non-cancer
|
354,961
|
96.8
|
183,844
|
92.5
|
19.8
|
1
|
0.502
|
1
|
0.02
|
|
Cancer survivor
|
11,810
|
3.2
|
5962
|
2.8
|
20.7
|
1.02 (0.96–1.09)
|
1.07 (1.01–1.12)
|
|
Sex
|
|
Males
|
193,646
|
52.8
|
98,246
|
50.6
|
19.4
|
1
|
< 0.001
|
1
|
< 0.001
|
|
Females
|
173,125
|
47.2
|
91,560
|
44.7
|
20.5
|
1.05 (1.04–1.06)
|
1.05 (1.04–1.06)
|
|
Age (yrs)
|
|
40–49
|
44,088
|
12.0
|
26,453
|
9.8
|
27.1
|
1
|
< 0.001
|
1
|
< 0.001
|
|
50–59
|
95,539
|
26.1
|
51,099
|
24.5
|
20.8
|
0.81 (0.80–0.82)
|
0.80 (0.79–0.82)
|
|
60–69
|
126,570
|
34.5
|
60,763
|
34.9
|
17.4
|
0.69 (0.68–0.70)
|
0.66 (0.65–0.67)
|
|
70–79
|
75,425
|
20.6
|
37,647
|
20.5
|
18.4
|
0.73 (0.71–0.75)
|
0.68 (0.67–0.70)
|
|
80+
|
25,149
|
6.9
|
13,844
|
5.7
|
24.2
|
0.89 (0.85–0.93)
|
1.14 (1.05–1.24)
|
|
BMI (kg/m2)
|
|
< 18.5
|
3035
|
0.8
|
1773
|
0.6
|
28.9
|
1.25 (1.20–1.30)
|
< 0.001
|
1.18 (1.14–1.23)
|
< 0.001
|
|
18.5–25
|
90,123
|
24.6
|
48,251
|
22.6
|
21.3
|
1
|
1
|
|
≥ 25
|
273,613
|
74.6
|
139,782
|
72.1
|
19.4
|
0.92 (0.91–0.93)
|
0.94 (0.93–0.95)
|
|
Cholesterol (mmol/L)
|
|
Normal (< 5)
|
59,402
|
16.2
|
29,003
|
15.8
|
18.4
|
1
|
< 0.001
| | |
|
Mod-High (5–8)
|
279,538
|
76.2
|
146,489
|
72.4
|
20.2
|
1.10 (1.09–1.11)
| | |
|
High (> 8)
|
24,778
|
6.8
|
12,533
|
6.8
|
18.5
|
1.01 (0.99–1.03)
| | |
|
Missing
|
3053
|
0.8
| | | | | | | |
|
Smoking status
|
|
Never smoker
|
117,658
|
32.1
|
61,055
|
31.1
|
19.6
|
1
|
< 0.001
|
1
|
< 0.001
|
|
Ex-smoker
|
169,393
|
46.2
|
84,172
|
45.3
|
18.6
|
0.94 (0.93–0.96)
|
0.98 (0.96–0.99)
|
|
Current smoker
|
79,720
|
21.7
|
44,579
|
19.0
|
23.5
|
1.16 (1.14–1.17)
|
1.13 (1.12–1.15)
|
|
Alcohol status
|
|
Non-drinker
|
76,637
|
20.9
|
40,349
|
20.0
|
20.2
|
1
|
< 0.001
| | |
|
Ex-drinker
|
13,239
|
3.6
|
6783
|
3.6
|
18.9
|
0.95 (0.92–0.97)
| | |
|
Current drinker
| | | | | | | | |
|
light
|
143,351
|
39.1
|
72,291
|
39.2
|
18.4
|
0.93 (0.90–0.95)
| | |
|
moderate
|
16,097
|
4.4
|
8198
|
4.3
|
18.9
|
0.95 (0.91–0.99)
| | |
|
heavy
|
19,720
|
5.4
|
10,777
|
4.7
|
22.8
|
1.09 (1.07–1.12)
| | |
|
amount unknown
|
10,869
|
3.0
|
5772
|
2.8
|
20.3
|
1.01 (0.96–1.05)
| | |
|
Missing
|
86,858
|
23.7
| | | | | | | |
|
Medical history
|
|
Diabetes
|
70,990
|
19.4
|
34,520
|
19.9
|
17.3
|
0.87 (0.85–0.88)
|
< 0.001
|
0.83 (0.82–0.84)
|
< 0.001
|
|
Chronic kidney disease
|
25,278
|
6.9
|
12,243
|
5.7
|
21.4
|
1.01 (0.98–1.05)
|
< 0.001
| | |
|
Chronic liver disease
|
6440
|
1.8
|
3395
|
1.4
|
23.5
|
1.12 (1.08–1.16)
|
< 0.001
| | |
|
IMD quintile
|
|
1 (least deprived)
|
40,769
|
11.1
|
21,052
|
11.7
|
18.0
|
1
|
< 0.001
| | |
|
2
|
43,256
|
11.8
|
22,097
|
11.9
|
18.6
|
1.01 (0.97–1.06)
| | |
|
3
|
48,504
|
13.2
|
24,908
|
13.1
|
19.1
|
1.03 (0.98–1.09)
| | |
|
4
|
187,806
|
51.2
|
98,030
|
46.1
|
21.3
|
1.11 (1.06–1.17)
| | |
|
5 (most deprived)
|
46,436
|
12.7
|
23,719
|
12.6
|
18.8
|
1.03 (0.97–1.09)
| | |
|
Calendar year
|
|
2005–07
|
155,758
|
42.5
|
86,412
|
56.6
|
15.3
|
1
|
< 0.001
| | |
|
2008–10
|
124,788
|
34.0
|
67,538
|
30.1
|
22.5
|
1.27 (1.26–1.29)
| | |
|
2011–13
|
86,225
|
23.5
|
35,856
|
8.7
|
41.3
|
1.52 (1.50–1.55)
| | |
- aEvents = first cessation of statin therapy defined as a no further prescriptions 90 days after the expected end date of the last prescription
- bCox model with time since study entry (i.e. statin initiation) as the timescale
- cAdjusted for a priori confounders [age (time-updated), gender, body mass index, smoking status and diabetes (time-updated)]. No other covariates changed the association between cancer survivorship and statin cessation by more than 10%.
- All regression models are restricted to patients with complete data for a-priori confounders
