Potential Protective Effect of Statins Against High-Grade Squamous Intraepithelial Lesions (HSIL) in Women with Metabolic Comorbidities
Menée à partir de données de dossiers médicaux électroniques portant sur 2 378 femmes présentant des lésions cervicales intraépithéliales, cette étude analyse l'association entre une utilisation de statines et le grade des lésions, en fonction de la présence de comorbidités et de l'origine ethnique
Background: While HPV vaccination and Pap screening have advanced cervical cancer (CCa) prevention, high-grade squamous intraepithelial lesions (HSIL) remain common, particularly among individuals with metabolic comorbidities like diabetes and hypercholesterolemia. Statins, commonly used for lipid control, possess anti-inflammatory and antiproliferative properties that may offer protective effects against cervical dysplasia. We explored the association between statin use and lesion grade in a population of dysplasia patients, and whether effects vary by comorbidity and race.
Methods: Cross-sectional, observational retrospective analysis of electronic health records and billing data for 2,378 non-Latina/e (nL) Black and nL white patients diagnosed with LSIL or HSIL between 2014 - 2021 at a large academic medical center. Logistic regression assessed associations between statin use, comorbidity profiles (diabetes, hypercholesterolemia), race, and HSIL vs. LSIL, adjusting for potential confounders. Interaction terms were tested to evaluate effect modification.
Results: Statin users had significantly lower odds of HSIL than nonusers (adjusted OR=0.48, p<0.0001), despite being older, with higher comorbidity rates. Predicted HSIL probabilities ranged from 4% - 20% in statin users versus 13% to 29% in nonusers. The lowest risk was observed among diabetic patients on statins, particularly among nL Black patients, suggesting a possible synergistic protective effect in metabolically vulnerable populations. Only 35% of patients with a hypercholesterolemia diagnosis listed were on statins.
Conclusions: Statin use was associated with substantially lower HSIL risk, particularly among nL Black patients with diabetes.
Impact: These findings support further investigation of statins as a potential low-cost chemopreventive tool for cervical dysplasia, especially in populations with metabolic dysfunction.
Cancer Epidemiology, Biomarkers & Prevention , résumé, 2025