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.

Inverse association between statin use and head and neck cancer: Population‐based case‐control study in Han population

“…[14][15][16][17][18][19][20][21] However, to date, although head and neck cancer cells are considered to be sensitive to statins, most previous studies only attempted to find the relationship between statins and many types of cancers, but not head and neck cancers. [22][23][24][25][26][27] Only 1 Western study mentioned that statin usage may decrease the risk of death from pharynx cancer. 28 No prior study explored the connection between statins and the incidence of head and neck cancers.…”

Risk of Cause‐Specific Death in Individuals with Cancer—Modifying Role Diabetes, Statins and Metformin

“…Statin therapy is frequently used in diabetic patients for the prevention of cardiovascular complications, but a recent large meta‐analysis showed that statin therapy was associated with reduced cancer‐specific mortality as well (HR 0.60, 0.47–0.77) . Conversely, recently some observational studies, and clinical trials have not detected any effect on survival.…”

Adjuvant statin therapy for oesophageal adenocarcinoma: the STAT-ROC feasibility study

“…Preclinical studies 7 -10 have demonstrated antiproliferative, proapoptotic and antimetastatic effects of statins in OAC. A recent systematic review 14 of observational studies, which included 95 cohorts with over a million patients with cancer at numerous primary sites, demonstrated that statin use after diagnosis was associated with significant reductions in all-cause mortality (pooled hazard ratio (HR) 0⋅65, 95 per cent c.i. A recent systematic review 14 of observational studies, which included 95 cohorts with over a million patients with cancer at numerous primary sites, demonstrated that statin use after diagnosis was associated with significant reductions in all-cause mortality (pooled hazard ratio (HR) 0⋅65, 95 per cent c.i.…”