Statins and cancer risk: A literature-based meta-analysis and meta-regression analysis of 35 randomized controlled trials

被引:148
作者
Bonovas, Stefanos
Filioussi, Kalitsa
Tsavaris, Nikolaos
Sitaras, Nikolaos M.
机构
[1] Univ Athens, Sch Med, Dept Pharmacol, GR-11527 Athens, Greece
[2] Univ Athens, Sch Med, Dept Pathophysiol, GR-11527 Athens, Greece
[3] Hellen Ctr Dis Control & Prevent, Dept Epidemiol Surveillance & Intervent, Athens, Greece
关键词
D O I
10.1200/JCO.2006.06.3560
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose 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). Conclusion 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.
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收藏
页码:4808 / 4817
页数:10
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