Statins and Cancer Risk
A Meta-analysis

Krista M. Dale, PharmD; Craig I. Coleman, PharmD; Nickole N. Henyan, PharmD;
Jeffrey Kluger, MD; C. Michael White, PharmD

JAMA. 2006;295:74-80.

Context  Statins are cholesterol-lowering drugs that have been proven in
randomized controlled trials to prevent cardiac events. Recent retrospective
analyses have suggested that statins also prevent cancer.

Objectives  To investigate the effect of statin therapy on cancer incidence
and cancer death and to analyze the effect of statins on specific cancers
and the effect of statin lipophilicity or derivation.

Data Sources  A systematic literature search of MEDLINE, EMBASE, CINAHL, Web
of Science, CANCERLIT, and the Cochrane Systematic Review Database through
July 2005 was conducted using specific search terms. A review of cardiology
and cancer abstracts and manual review of references was also performed.

Study Selection  Twenty-seven of the 8943 articles (n = 86 936 participants)
initially identified met the inclusion criteria, reporting 26 randomized
controlled trials of statins, with a mean duration of follow-up of at least
1 year, enrolling a minimum of 100 patients, and reporting data on either
cancer incidence (n = 20 studies) or cancer death (n = 22 studies).

Data Extraction  All data were independently extracted by 3 investigators
using a standardized data abstraction tool. Weighted averages were reported
as odds ratios (ORs) with 95% confidence intervals (CIs) using a
random-effects model (DerSimonian and Laird methods). Statistical
heterogeneity scores were assessed with the Q statistic.

Data Synthesis  In meta-analyses including 6662 incident cancers and 2407
cancer deaths, statins did not reduce the incidence of cancer (OR, 1.02; 95%
CI, 0.97-1.07) or cancer deaths (OR, 1.01; 95% CI, 0.93-1.09). No reductions
were noted for any individual cancer type. This null effect on cancer
incidence persisted when only hydrophilic, lipophilic, naturally derived, or
synthetically derived statins were evaluated.

Conclusions  Statins have a neutral effect on cancer and cancer death risk
in randomized controlled trials. We found that no type of cancer was
affected by statin use and no subtype of statin affected the risk of cancer.

Author Affiliations: University of Connecticut School of Pharmacy, Storrs
(Drs Dale, Coleman, Henyan, and White); University of Connecticut School of
Medicine, Farmington (Dr Kluger); and Divisions of Cardiology (Drs Dale,
Coleman, Henyan, Kluger, and White) and Drug Information (Drs Dale, Coleman,
Henyan, and White), Hartford Hospital, Hartford, Conn.