Evaluating the impact of pre-diagnostic use of statins and testosterone replacement therapy on mortality outcomes in older men with hormone-related cancers: Surveillance, Epidemiology, and End Results-Medicare 2007-2015.

Pre-diagnostic statin use alone was associated with an 11% reduced risk of hormone-related cancer-specific death among high-grade hormone-related cancers in competing-risks models.

• Finding was observed in Fine-Gray competing risk models, not in Cox proportional hazard models
• Hazard ratio: 0.89; 95% confidence interval: 0.81-0.99; p = 0.0451
• Analysis restricted to high-grade hormone-related cancer cases
• Study population included 41,707 men aged ≥65 years from SEER-Medicare 2007-2015

Pre-diagnostic testosterone replacement therapy (TRT) alone was associated with a 24% lower risk of all-cause death in the prostate cancer cohort.

• Hazard ratio: 0.76; 95% confidence interval: 0.59-0.97; p = 0.0325
• Finding was consistent in both Cox proportional hazards and Fine-Gray competing risk models
• The prostate cancer cohort comprised 31,097 cases
• TRT use was assessed as pre-diagnostic prescription

Pre-diagnostic TRT alone was associated with a 57% lower risk of prostate cancer-specific death in the prostate cancer cohort.

• Hazard ratio: 0.43; 95% confidence interval: 0.24-0.75; p = 0.0029
• Finding was consistent across both Cox proportional hazards and Fine-Gray competing risk models
• This represents the strongest mortality association found in the study
• Analysis was conducted among 31,097 prostate cancer cases

Similar inverse associations were found among aggressive prostate cancer cases for both TRT alone and statins alone.

• Inverse associations with TRT alone and statins alone were observed specifically in the aggressive prostate cancer subgroup
• Findings were consistent across both statistical models used
• No specific hazard ratios for the aggressive prostate cancer subgroup are provided in the abstract
• Aggressive prostate cancer was analyzed as a distinct subgroup within the 31,097 prostate cancer cases

No significant associations were found between pre-diagnostic statin or TRT use and mortality outcomes in colorectal cancer or male breast cancer subgroups.

• Colorectal cancer cohort comprised 10,315 cases
• Male breast cancer cohort comprised 295 cases
• Neither Cox proportional hazards nor Fine-Gray models showed significant associations in these subgroups
• All four exposure groups (neither users, statins alone, TRT alone, and dual users) were examined

No significant associations were found in Cox proportional hazard models for hormone-related cancers overall.

• The lack of significance in Cox models contrasts with findings in Fine-Gray competing risk models for high-grade cancers
• Total study population was 41,707 men aged ≥65 years from SEER-Medicare 2007-2015
• Multivariable-adjusted models were used for both statistical approaches
• The discrepancy between models suggests the importance of accounting for competing risks in cancer mortality studies

The study population consisted of 41,707 older men with hormone-related cancers identified from SEER-Medicare data spanning 2007-2015.

• Cohort included 31,097 prostate cancer cases, 10,315 colorectal cancer cases, and 295 male breast cancer cases
• All participants were aged ≥65 years
• Pre-diagnostic prescription of statins and TRT was categorized into four groups: neither users, statins alone, TRT alone, and dual users
• Both Cox proportional hazards and Fine-Gray subdistribution hazard (competing-risks) models were employed