title: Effects of statins on cancer mortality and progression: A systematic review and meta-analysis of 95 cohorts including 1,111,407 individuals.
abstract: Statins have been implicated in the regulation of cell proliferation, apoptosis and tumor progression in cancer patients and statin use at the time of cancer diagnosis has been reported to be associated with reduced cancer risk and improved survival, irrespective of concomitant anti-cancer therapy. A systematic literature search of relevant databases through May 2015 was conducted to identify studies assessing the prognostic impact of statin use on prognostic outcomes in cancer patients. Literature search identified 95 cohort studies that met the inclusion criteria. A meta-analysis of 55 articles showed that statin use was significantly associated with decreased risk of all-cause mortality (HR 0.70, 95% Cl 0.66 to 0.74) compared with nonusers. The observed pooled estimates were retained for cancer-specific mortality (HR 0.60, 95% Cl 0.47 to 0.77), progression-free survival (HR 0.67, 95% Cl 0.56 to 0.81), recurrence-free survial (HR 0.74, 95% Cl 0.65 to 0.83) and disease-free survival (HR 0.53, 95% Cl 0.40 to 0.72). These associations almost remained consistent across those outcomes when stratified by publication type, tumour location, study design, sample size, initiation of statins, disease stage, research country, follow-up duration or research hospital involved. Subgroup analyses according to initiation of statins showed postdiagnosis statin users (HR 0.65, 95% Cl 0.54 to 0.79) gained significantly more recurrence-free survival benefit than prediagnosis statin users (HR 0.86, 95% Cl 0.77 to 0.96) (p for interaction = 0.018). Statin therapy has potential survival benefit for patients with malignancy. Further large-scale prospective studies emphasising survival outcomes of individual cancer type are strongly encouraged.
authors.affiliation: Department of Anorectal Surgery, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
authors.forename: Zubing
authors.initials: Z
authors.lastname: Mei
authors.affiliation: Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China.|Hunan Key Laboratory of Psychiatry and Mental Health, Mental Health Institute of the Second Xiangya Hospital, Central South University, Chinese National Clinical Research Center on Mental Disorders (Xiangya), Chinese National Technology Institute on Mental Disorders, Changsha, Hunan Province, China.
authors.forename: Mining
authors.initials: M
authors.lastname: Liang
authors.affiliation: Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China.|Hunan Key Laboratory of Psychiatry and Mental Health, Mental Health Institute of the Second Xiangya Hospital, Central South University, Chinese National Clinical Research Center on Mental Disorders (Xiangya), Chinese National Technology Institute on Mental Disorders, Changsha, Hunan Province, China.|Department of Nursing, the Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
authors.forename: Lezhi
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of pharmacy, the First People's Hospital of Jiashan, Jiashan County, Jiaxing City, Zhejiang Province, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Anorectal Surgery, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
authors.forename: Qingming
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Department of Anorectal Surgery, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Yang
mesh_terms: D002423:Cause of Death; D015331:Cohort Studies; D018450:Disease Progression; D004198:Disease Susceptibility; D018572:Disease-Free Survival; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D009026:Mortality / Q000639:trends; D015337:Multicenter Studies as Topic; D009369:Neoplasms / Q000401:mortality* / Q000503:physiopathology; D011446:Prospective Studies; D012189:Retrospective Studies
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: cancer; meta-analysis; mortality; progression; recurrence; statins