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Epidemiology

Post-diagnosis statin use and survival among head and neck cancer patients: a cohort study in a universal health care system

British Journal of Cancer volume 132, pages 259–265 (2025)Cite this article

Subjects

Abstract

Background

Little research has been conducted on the relationship between statin use and the survival of head and neck cancer patients. This study assessed whether statin use after head and neck cancer diagnosis is associated with overall survival among patients in the U.S. military health system (MHS) that provides universal health care to its beneficiaries.

Methods

The study included 1842 patients with head and neck squamous cell carcinoma (HNSCC) from MHS. Statin use was extracted from the pharmacy database of the Military Health System Data Repository (MDR). Time-dependent multivariate Cox proportional hazards models were used to assess the relationship between post-diagnosis statin use and overall survival with the adjustment for potential confounders.

Results

Compared to non-users, increased post-diagnosis cumulative use of statins (per one-year of use) conferred a significant improved survival with adjusted hazard ratio (HR) of 0.70 (95% Confidence Interval, CI = 0.55 to 0.90). When analysis was stratified by status of statin use prior to HNSCC diagnosis, the HRs were 0.31 (95% CI = 0.15–0.65) and 0.81 (95% CI = 0.59–1.11) for post-diagnosis users who also used it before HNSCC diagnosis and those who only used it after the diagnosis, respectively.

Conclusion

Prolonged statin use was associated with improved survival among HNSCC patients in MHS.

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Data availability

The dataset generated during and/or analyzed during the current study is not publicly available following DoD MHS regulations.

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Acknowledgements

The authors thank Joint Pathology Center for providing the Central Cancer Registry (CCR) data and the Defense Health Agency for providing the MHS Data Repository (MDR) data.

Funding

This project was supported by Murtha Cancer Center Research Program via Uniformed Services University of the Health Sciences under the auspices of the Henry M. Jackson Foundation for the Advancement of Military Medicine.

Author information

Authors and Affiliations

  1. Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA

    Jie Lin, Craig D. Shriver & Kangmin Zhu

  2. Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA

    Jie Lin, Michael I. Orestes, Craig D. Shriver & Kangmin Zhu

  3. Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA

    Jie Lin & Kangmin Zhu

  4. The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA

    Jie Lin & Kangmin Zhu

  5. Department of Surgery, Walter Reed National Military Medical Center, Bethesda, MD, USA

    Michael I. Orestes & Craig D. Shriver

Authors
  1. Jie Lin
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  2. Michael I. Orestes
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  3. Craig D. Shriver
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  4. Kangmin Zhu
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Contributions

Conception: Lin, Zhu; Data Curation: Lin, Zhu, Shriver; Formal Analysis: Lin; Funding Acquisition: Shriver; Methodology: Lin, Zhu, Orestes, Shriver; Investigation: Lin, Zhu, Orestes, Shriver; Writing –original draft: Lin; Writing-review and editing: Lin, Orestes, Zhu, Shriver

Corresponding authors

Correspondence to Jie Lin or Kangmin Zhu.

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Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

The MilCanEpi database and its utilization were approved by the Institutional Review Board of the Uniformed Services University of the Health Sciences, and Defense Health Agency (DHA). The study was performed in accordance with the Declaration of Helsinki. The study used deidentified data stored in the MilCanEpi database. Obtaining informed consent does not apply.

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Lin, J., Orestes, M.I., Shriver, C.D. et al. Post-diagnosis statin use and survival among head and neck cancer patients: a cohort study in a universal health care system. Br J Cancer 132, 259–265 (2025). https://doi.org/10.1038/s41416-024-02925-y

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