Statins and the Risk of Gastric Cancer: A Systematic Review and Meta-Analysis

Abstract

Previous epidemiological studies have reported that the use of statins is associated with a decreased risk of gastric cancer, although the beneficial effects of statins on the reduction of gastric cancer remain unclear. Therefore, we conducted a systematic review and meta-analysis to investigate the association between the use of statins and the risk of gastric cancer. Electronic databases such as PubMed, EMBASE, Scopus, and Web of Science were searched between 1 January 2000 and 31 August 2022. Two authors used predefined selection criteria to independently screen all titles, abstracts, and potential full texts. Observational studies (cohort and case-control) or randomized control trials that assessed the association between statins and gastric cancer were included in the primary and secondary analyses. The pooled effect sizes were calculated using the random-effects model. The Meta-analysis of Observational Studies in Epidemiology (MOOSE) reporting guidelines were followed to conduct this study. The total sample size across the 20 included studies was 11,870,553. The use of statins was associated with a reduced risk of gastric cancer (RRadjusted: 0.72; 95%CI: 0.64–0.81, p < 0.001). However, the effect size of statin use on the risk of gastric cancer was lower in Asian studies compared to Western studies (RRAsian: 0.62; 95%CI: 0.53–0.73 vs. RRwestern: 0.88; 95%CI: 0.79–0.99). These findings suggest that the use of statins is associated with a reduced risk of gastric cancer. This reverse association was even stronger among Asian people than Western individuals.

Correlation of various lipid-lowering and hypoglycemic drugs with the risk of gastric cancer in elderly population

“…The above findings are in line with some of the epidemiological findings from outside China [5][6][7][8]. Moreover, several more in-depth studies have been carried out by some scholars.…”

“…They are as follows: (1) Controls were selected according to a ratio of 1:2; (2) As there were significantly more men than women with GC, controls were required to match each group in terms of gender; (3) No previous malignancy of any type; (4) History of previous illnesses as well as medication history were clearly documented in the medical history of the examination; (5) Those who agree to participate in this study and sign the informed consent form.…”

“…It is well known that lipid-lowering and hypoglycaemic drugs are two classes of drugs commonly used in the elderly. Studies outside China have shown that statin lipid-lowering drugs have a protective effect against GC, but this effect may vary among regions and populations [5,6]. Other studies have also shown that the hypoglycaemic drug, metformin may reduce the risk of developing GC [7,8].…”

Anti-Inflammatory Effects of Lipid-Lowering Drugs and Supplements—A Narrative Review

“…Studies have shown that the impact of statins on human health is beyond simple LDL lowering, which is also named “statin pleiotropy” [ 26 , 27 ]. So far, statins exhibited anti-inflammatory effects and benefits in diseases related to inflammation: atherosclerosis [ 28 ], chronic heart failure [ 29 ], sepsis [ 30 ], COVID-19 [ 31 ], diabetic nephropathy [ 32 ], gastric cancer [ 33 , 34 ], Alzheimer’s diseases [ 35 ], bone disorders [ 36 ], and autoimmune diseases [ 37 ]. Meta-analysis of 15 randomized controlled trials provided evidence that lipophilic statins pose more pleiotropic effects compared to hydrophilic statins due to easier penetration into the cell membranes [ 38 ].…”

Exposure to Commonly Used Drugs and the Risk of Gastric Cancer: An Umbrella Review of Meta-Analyses

“…However, the preventative effects of medications such as statins, aspirin, metformin, and proton pump inhibitors (PPIs) against GC remain controversial. Additionally, several systematic reviews and metaanalyses investigated medication use and GC risk [16,17], but in fact, no attempts have been made to quantify the credibility of these findings. Given the uncertainty of observational research, this quantification of evidence is both timely and critical [18,19].…”