Risk of ulcerated melanoma low among statin users, high among diabetics
Use of statins cuts the risk of ulcerated melanoma, whereas diabetes heightens the likelihood of developing ulcerated vs nonulcerated melanoma, according to a study.
The cross-sectional study included 787 patients with stage IB or II melanoma (mean age at diagnosis 62 years; 57 percent male). Of these, 194 had ulcerated tumours. Relative to patients without ulceration, those with ulcerated melanoma were more likely to be older, male, have outdoor occupations, thicker melanomas and higher numbers of mitoses.
Regression models showed regular statin use to be associated with a lower likelihood of a diagnosis of ulcerated primary melanoma (odds ratio [OR], 0.67; 95 percent CI, 0.45 to 0.99). This association persisted despite controlling for age, sex, thickness and mitosis.
Researchers noted that other medications with anti-inflammatory properties—such as aspirin, nonsteroidal anti-inflammatory drugs and corticosteroids—also demonstrated strong inverse associations with ulcerated melanomas.
When analysis was limited to melanomas that were ≤2 mm thick and had ≤2 mitoses/mm2 (40 ulcerated; 289 without ulceration), the odds of having a diagnosis of ulcerated melanoma were greater among patients with diabetes than among those without (OR, 2.90; 1.07 to 7.90). This increased likelihood remained even after adjustments for age, sex, body mass index and statin use.
Traditionally indicated for lowering cholesterol levels, statins are increasingly recognized for their anticancer effects—regulating tumour proliferation, apoptosis, angiogenesis and metastasis as a result of inhibiting metabolic products of the 3-hydroxy-3-methylglutaryl coenzyme A reductase reaction. [Oncologist 2006;11:306-315; Int J Cancer 2017;140:747-755]
Researchers explained that statins may reduce the likelihood of being diagnosed with an ulcerated vs nonulcerated melanoma by potentially modifying inflammatory mechanisms involved in tumour ulceration. Such modification may, at least in part, account for the reduced melanoma progression and metastasis observed in regular statin users. [Curr Cancer Drug Targets 2005;5:579-594]