Statin use and cancer risk: a comprehensive review.
BACKGROUND
HMG-CoA inhibitors (statins), a class of drugs that reduce cholesterol, are used to manage and prevent coronary heart disease. They are among the most commonly prescribed drugs worldwide. Contrary to early concerns over the carcinogenicity of statins, a growing body of evidence suggests statins may in fact have a chemopreventive potential against cancer.


METHODS
In this paper, we review evidence on the association between statin use and cancer risk. Specifically, we report on clinical trials and observational studies that measured all cancer or site-specific cancers of the breast, colorectal, lung, prostate and reproductive organs associated with statin use.


RESULTS
An understanding of the evidence, including strengths and limitations, to support an association between statins and cancer. Information on the current state of the field and future directions are also discussed.


CONCLUSIONS
Few strong or consistent associations between statins and cancer incidence overall or for any of the sites reviewed were detected. Data for any effects of statins on cancer prognosis and secondary prevention are lacking; with the exception of consistent evidence that statins are associated with reduced risk of advanced/aggressive prostate cancer. Statins appear safe in relation to cancer risk but any chemopreventive effect in humans remains to be established and should not be recommended outside the context of clinical trials. It is encouraging that numerous trials are ongoing. The prospect of reducing the incidence and burden of some of the most prevalent cancers with safe, affordable and tolerable medication that already reduces the risk of the leading cause of death and cardiovascular disease warrants further exploration in clinical trials and observational studies of prognosis and survival.
Boudreau
Denise M
DM
Group Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA 98101, USA. boudreau.d@ghc.org
Yu
Onchee
O
Johnson
Jeanene
J
D000818:Animals; D016588:Anticarcinogenic Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000453:epidemiology; D015179:Colorectal Neoplasms / Q000453:epidemiology; D016889:Endometrial Neoplasms / Q000453:epidemiology; D005260:Female; D005705:Gallbladder Diseases / Q000188:drug therapy; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D008175:Lung Neoplasms / Q000453:epidemiology; D008297:Male; D009369:Neoplasms / Q000453:epidemiology*; D010051:Ovarian Neoplasms / Q000453:epidemiology; D011471:Prostatic Neoplasms / Q000453:epidemiology; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors
D016588:Anticarcinogenic Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors