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Purpose: Inconsistent results of lipid-lowering medications (LLMs) on improved cancer survival need more investigations. We tested the hypothesis that adherence to the drug would be associated with a lower cancer-specific mortality in a homogeneous population who has ever used the drug. Methods: Utilising data from the Australian Cancer database, linked to the Pharmaceutical Benefits Scheme data and the National Death Index, we identified two separate cohorts of 4519 and 3083 women patients with newly diagnosed endometrial and lung cancer respectively between 2003 and 2013. Adherence to this drug was calculated by proportion of days covered. Cox regression models with time-varying covariates were used to estimate the multivariable-adjusted cause-specific hazard ratios (HRs) and 95% confidence intervals (CIs) for the association of adherence to LLMs, statins, lipophilic and hydrophilic statins, and cancer-specific mortality. Results: Each 10% increase in 1-year adherence to LLMs reduced cancer-specific mortality among women with endometrial cancer (adjusted HR=0.93, 95% CI 0.90–0.96) or lung cancer (adjusted HR=0.95, 95% CI 0.93–0.97). The inverse associations remained unchanged in different subgroup analyses. The reductions in lung cancer mortality were not apparent for women who adhered to lipophilic statins albeit better endometrial cancer survival appeared in the lipophilic statin group and borderline statistical improvement in the hydrophilic statin group. Conclusions: Among LLM users, adherence to this drug is inversely associated with reduced cancer-specific mortality. Together with previous evidence, randomised controlled trials are called for to confirm whether LLMs could be considered as an adjuvant treatment to improve prognosis. [ABSTRACT FROM AUTHOR]

Objectives: To (a) compare palliative care needs of lung cancer patients on their final admission to community‐based and inpatient palliative care services; and (b) explore whether and how these care needs affect their utilisation of different palliative care services in the last days of life. Methods: Descriptive study involving 17,816 lung cancer patients who received the last episode of palliative care from specialist services and died between 1 January 2013 and 31 December 2018. Results: Both groups of patients admitted to community‐based and inpatient palliative care services generally experienced relatively low levels of symptom distress, but high levels of functional impairment and dependency. "Unstable" versus "stable" palliative care phase (Odds ratio = 11.66; 95% Confidence Interval: 9.55–14.24), poorer functional outcomes and severe levels of distress from many symptoms predicted greater likelihood of use of inpatient versus community‐based palliative care. Conclusions: Most inpatient palliative care admissions are not associated with high levels of symptom severity. To extend the period of home care and rate of home death for people with lung cancer, additional investment is required to improve their access to sufficiently skilled palliative care staff, multi‐disciplinary teams and 24‐hour home support in community settings. [ABSTRACT FROM AUTHOR]

Aims: Equivocal results of association between metformin and cancer-specific survival need more investigation. We tested the hypothesis that adherence to the drug had a lower cancer-specific mortality in a homogeneous population (i.e. regular users).Methods: The Australian Cancer database was linked to the Pharmaceutical Benefits Scheme data and the National Death Index. Adherence to metformin was calculated by proportion of days covered. Cox regression models with time-varying covariates were used to estimate multivariable-adjusted cause-specific hazard ratios (HRs) and 95% confidence intervals (CI) for the association of adherence to metformin and cancer-specific mortality.Results: Between 2003 and 2013, three separate cohorts of 6717, 3121, and 1854 female patients were identified with newly diagnosed breast, colorectal, or endometrial cancer. The 1-year adherence was similar at baseline in three cohorts, on average 75%. Each 10% increase in 1-year adherence to metformin reduced cancer-specific mortality among women with breast cancer (adjusted HR = 0.95; 95% CI, 0.93-0.97), colorectal cancer (adjusted HR = 0.94; 95% CI, 0.91-0.96), or endometrial cancer (adjusted HR = 0.95; 95% CI, 0.90-0.99). The inverse associations remained unchanged in most subgroup analyses.Conclusions: Among metformin users, adherence to this drug is inversely associated with reduced cancer-specific mortality. If confirmed, metformin could be considered as an adjuvant treatment. [ABSTRACT FROM AUTHOR]