Although a plausible pharmacological mechanism for statin-associated cancer is unknown, there are several noteworthy potential explanations. The relationship between serum cholesterol levels and the risk of cancer is an area of considerable research and debate. The literature on cholesterol and cancer has demonstrated an inverse relationship between total serum cholesterol levels and incident cancer. There are a number of studies suggesting that an excessively low level of total cholesterol might be an increased risk for cancer mortality. Recently, some studies have reported that lower levels of LDL-C are associated with higher rates of incident cancers. Kikuchi et al. suggested that lower serum levels of total cholesterol are associated with higher oxidative DNA damage and linking to an increased risk of cancer. Oxidative DNA stress is thought to play a major role in carcinogenesis. As our study did not examine serum levels of cholesterol, the association of the cholesterol level with cancer risk is unknown. However, it was noteworthy that significant associations with increased risks of cancers were predominantly found for high potency statins such as atorvastatin, rosuvastatin, and pitavastatin. Treatment with high potency statins may result in a lower level of cholesterol than other statin therapy.