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To the Editor: We believe that the conclusion from the meta-analysis by Dr Dale and colleagues¹ that statin therapy has no effect on prostate cancer should be viewed with skepticism. Although the study considered randomized placebo-controlled trials exclusively, these trials were not designed to assess cancer incidence or mortality. Only 3 of 26 trials reported specific prostate cancer incidence data (305 cases), and only 1 of 26 trials reported prostate cancer–specific mortality, with only 2 deaths. The duration of 17 of 26 trials in the meta-analysis was 4 years or less. For prostate cancer and other cancers with a prolonged clinical course, effects on incidence or cancer-specific survival would not likely arise during the study period; stage-specific indicators would be needed to observe any treatment effects.²

In addition, no conclusion can be drawn about the benefits arising from reductions in cholesterol synthesis or circulating cholesterol levels, which have emerged in . . . [Full Text of this Article]

Michael R. Freeman, PhD
michael.freeman@childrens.harvard.edu
Urological Diseases Research Center

Keith R. Solomon, PhD
Department of Orthopaedic Surgery
Children's Hospital Boston
Boston, Mass

Mark Moyad, MD
Department of Urology
University of Michigan Medical Center
Ann Arbor

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