To the Editor Emilsson et al suggest that earlier studies associating statin use with improved cancer outcomes were biased by inclusion of prevalent users and by immortal person-time. They emulated a randomized trial of statin use among survivors of colorectal, breast, prostate, and bladder cancer using Surveillance, Epidemiology, and End Results–Medicare data. After accounting for these biases, they observed a null association between postdiagnosis statin initiation and both cancer-specific and all-cause mortality.
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