title: Statins and cancer risk: a literature-based meta-analysis and meta-regression analysis of 35 randomized controlled trials.
abstract: 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.
authors.affiliation: Department of Pharmacology, School of Medicine, University of Athens, Greece. sbonovas@med.uoa.gr
authors.forename: Stefanos
authors.initials: S
authors.lastname: Bonovas
authors.forename: Kalitsa
authors.initials: K
authors.lastname: Filioussi
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Tsavaris
authors.forename: Nikolaos M
authors.initials: NM
authors.lastname: Sitaras
mesh_terms: 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
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors