Statins and cancer risk: a literature-based meta-analysis and meta-regression analysis of 35 randomized controlled trials.
OBJECTIVE
A growing body of literature suggests that statins may have chemopreventive potential against cancer. Our aim was to examine the strength of this association through a detailed meta-analysis and meta-regression analysis of randomized controlled trials (RCTs).


METHODS
A comprehensive search for trials published up to 2005 was performed, reviews of each study were conducted, and data were abstracted. Before meta-analysis, the studies were evaluated for publication bias and heterogeneity. Pooled relative risk (RR) estimates and 95% CIs were calculated using the random- and fixed-effects models. Subgroup, sensitivity, and meta-regression analyses were also conducted.


RESULTS
Thirty-five RCTs of statins for cardiovascular outcomes contributed to the analysis (n = 109,143). The degree of variability between trials was consistent with what would be expected to occur by chance alone. Statin use was not associated with a substantially increased or decreased overall risk of cancer (RR = 0.99; 95% CI, 0.94 to 1.04). Similarly, statin use did not significantly affect respiratory cancer risk (RR = 0.95; 95% CI, 0.83 to 1.09). However, the meta-regression analysis indicated that age of study participants modified the association between statin use and cancer risk (P = .003).


CONCLUSIONS
Our findings do not support a protective effect of statins against cancer. However, this conclusion is limited by the relatively short follow-up periods (4.5 years on average) of the studies analyzed. Thus, it is important to continue monitoring the long-term safety profiles of statins. Until then, physicians need to be vigilant in ensuring that statin use remains restricted to the approved indications.
Bonovas
Stefanos
S
Department of Pharmacology, School of Medicine, University of Athens, Greece. sbonovas@med.uoa.gr
Filioussi
Kalitsa
K
Tsavaris
Nikolaos
N
Sitaras
Nikolaos M
NM
D000367:Age Factors; D018890:Chemoprevention; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic; D012044:Regression Analysis; D018570:Risk Assessment
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors