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To the Editor: We are concerned that in the meta-analysis of statin use and cancer by Dr Dale and colleagues¹ the periods of follow-up and of statin use in the randomized controlled trials (RCTs) are too brief to have captured a true association between statin use and cancer risk or mortality. For prostate cancer and several other cancers analyzed in the meta-analysis, there is a well-recognized and often extended latency time between the initiation of cancer and clinical detection.² Although the median age at initial prostate cancer diagnosis is 69 years in the United States,³ autopsy studies have shown that prostatic intraepithelial neoplasia, a potential premalignant precursor, and histologic prostate cancer are evident in the third and fourth decades of life.^4-5 Thus, the critical period of cancer initiation likely occurred long before the time period evaluated in the statin RCTs for most of the prostate cancers observed in RCT participants. . . . [Full Text of this Article]

Claudia A. Salinas, MS; Ilir Agalliu, MD, ScD; Janet L. Stanford, PhD
jstanfor@fhcrc.org
Division of Public Health Sciences
Fred Hutchinson Cancer Research Center
Seattle, Wash

Daniel W. Lin, MD
Department of Medicine
University of Washington
Seattle

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