Article

Screening statins for possible carcinogenic risk: Up to 9 years of follow-up of 361,859 recipients

Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA, USA.
Pharmacoepidemiology and Drug Safety (Impact Factor: 3.17). 01/2008; 17(1):27-36. DOI: 10.1002/pds.1507
Source: PubMed

ABSTRACT Determine the risk of cancer in statin users.
Risk of cancer in up to 9.4 years after first recorded receipt of statins was evaluated in subscribers of an integrated health care program in northern California. Statin use and cancer development were ascertained from the program's pharmacy records and cancer registry from August 1994 to December 2003.
Most of the 361,859 statin users received lovastatin, simvastatin or both. Results are presented from analyses with 2-year lag and use for over 5 years. Most of the observed associations were likely due to chance or confounding. The few associations that seemed less readily explainable were increased risk of cancers of the thyroid, esophagus and urinary tract and decreased risk of colon cancer in men. Increased risk of lung cancer was the only nominally statistically significant positive association in women and could be partially attributable to their smoking habits.
Overall this study provided no strong evidence of either causation or prevention of cancer by statins.

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    • "ato et al . , 2006 ( Japan ) [ 13 ] { 14 ( 1991 – 2005 ) 215 2 f A 1 Flick et al . , 2007 ( U . S . ) [ 8 ] { 2 ( 2002 – 2004 ) 69 , 047 888 g B 1 – 3 Murtola et al . , 2007 ( Finland ) [ 14 ] 1 7 ( 1995 – 2002 ) 49 , 446 24 , 723 g C 1 , 11 – 17 Boudreau et al . , 2008 ( U . S . ) [ 25 ] { 2 ( 1990 – 2005 ) 83 , 372 2 , 532 g C 1 , 3 , 5 , 7 , 27 Friedman et al . , 2008 ( U . S . ) [ 34 ] { 9 ( 1994 – 2003 ) NR 1 , 706 e B 35 Smeeth et al . , 2008 ( U . K . ) [ 35 ] { 11 ( 1995 – 2006 ) 364 , 675 3 , 525 d B 1 , 3 , 9 , 11 – 14 , 27 , 28 , 35 – 38 Agalliu et al . , 2008 ( U . S . ) [ 37 ] 1 13 ( 2002 – 2005 )"
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    ABSTRACT: Background: Emerging evidence suggests that statins may decrease the risk of cancers. However, available evidence on prostate cancer (PCa) is conflicting. We therefore examined the association between statin use and risk of PCa by conducting a detailed meta-analysis of all observational studies published regarding this subject. Methods: Literature search in PubMed database was undertaken through February 2012 looking for observational studies evaluating the association between statin use and risk of PCa. Before meta-analysis, the studies were evaluated for publication bias and heterogeneity. Pooled relative risk (RR) estimates and 95% confidence intervals (CIs) were calculated using random-effects model (DerSimonian and Laird method). Subgroup analyses, sensitivity analysis and cumulative meta- analysis were also performed. Results: A total of 27 (15 cohort and 12 case-control) studies contributed to the analysis. There was heterogeneity among the studies but no publication bias. Statin use significantly reduced the risk of both total PCa by 7% (RR 0.93, 95% CI 0.87– 0.99, p = 0.03) and clinically important advanced PCa by 20% (RR 0.80, 95% CI 0.70–0.90, p,0.001). Long-term statin use did not significantly affect the risk of total PCa (RR 0.94, 95% CI 0.84–1.05, p = 0.31). Stratification by study design did not substantially influence the RR. Furthermore, sensitivity analysis confirmed the stability of results. Cumulative meta-analysis showed a change in trend of reporting risk from positive to negative in statin users between 1993 and 2011. Conclusions: Our meta-analysis provides evidence supporting the hypothesis that statins reduce the risk of both total PCa and clinically important advanced PCa. Further research is needed to confirm these findings and to identify the underlying biological mechanisms.
    PLoS ONE 10/2012; 7(10):e46691. · 3.53 Impact Factor
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    • "ato et al . , 2006 ( Japan ) [ 13 ] { 14 ( 1991 – 2005 ) 215 2 f A 1 Flick et al . , 2007 ( U . S . ) [ 8 ] { 2 ( 2002 – 2004 ) 69 , 047 888 g B 1 – 3 Murtola et al . , 2007 ( Finland ) [ 14 ] 1 7 ( 1995 – 2002 ) 49 , 446 24 , 723 g C 1 , 11 – 17 Boudreau et al . , 2008 ( U . S . ) [ 25 ] { 2 ( 1990 – 2005 ) 83 , 372 2 , 532 g C 1 , 3 , 5 , 7 , 27 Friedman et al . , 2008 ( U . S . ) [ 34 ] { 9 ( 1994 – 2003 ) NR 1 , 706 e B 35 Smeeth et al . , 2008 ( U . K . ) [ 35 ] { 11 ( 1995 – 2006 ) 364 , 675 3 , 525 d B 1 , 3 , 9 , 11 – 14 , 27 , 28 , 35 – 38 Agalliu et al . , 2008 ( U . S . ) [ 37 ] 1 13 ( 2002 – 2005 )"
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Emerging evidence suggests that statins may decrease the risk of cancers. However, available evidence on prostate cancer (PCa) is conflicting. We therefore examined the association between statin use and risk of PCa by conducting a detailed meta-analysis of all observational studies published regarding this subject.
    PLoS ONE 10/2012; 7(10-2):e46691. DOI:10.1371/journal.pone.0046691 · 3.53 Impact Factor
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    ABSTRACT: Purpose: In recent years, the potential risk of cancer associated with statin use has been a focus of much interest. However, it remains uncertain whether statin therapy is associated with cancer risk. To examine the association between statin use and the risk of cancer, we conducted data mining using the US Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) and a large organized database of claims constructed by a database vendor (The Japan Medical Data Center Co., Ltd, Tokyo, Japan [JMDC]). Methods: Relevant reports in the FAERS, which included data from the first quarter of 2004 through the end of 2012, were identified and analyzed. The reporting odds ratio (ROR) was used to detect spontaneous report signals and was calculated using the case/non-case method. Additionally, signals were detected via the information component (IC) using the IC025 metric. Furthermore, event sequence symmetry analysis (ESSA) was applied to identify the risk of cancer following treatment with statins over the period January 2005 to July 2013. Results: In the FAERS database analyses, significant signals for colorectal cancer and pancreatic cancer were found for statins as a class. In the ESSA, significant associations between statin use and colorectal cancer and pancreatic cancer were found, with adjusted sequence ratios (95% confidence intervals) of 1.20 (1.08-1.34) and 1.31 (1.13-1.53), respectively, at an interval of 48 months. Conclusions: Multi-methodological approaches using different algorithms and databases suggest that statin use is associated with an increased risk for colorectal cancer and pancreatic cancer.
    International journal of medical sciences 01/2015; 12(3):223-233. DOI:10.7150/ijms.10656 · 1.55 Impact Factor
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