TY - JOUR
TI - Statins and the risk of colorectal cancer: A meta-analysis of 18 studies involving more than 1.5 million patients
AU - Bonovas, S.
AU - Filioussi, K.
AU - Flordellis, C.S.
AU - Sitaras, N.M.
JO - Journal of Clinical Oncology
PY - 2007
VL - 25
TODO - 23
SP - 3462-3468
PB - 
SN - 0732-183X, 1527-7755
TODO - 10.1200/JCO.2007.10.8936
TODO - hydroxymethylglutaryl coenzyme A reductase inhibitor;  mevinolin;  placebo;  pravastatin;  simvastatin, article;  cancer risk;  case control study;  clinical trial;  colorectal cancer;  controlled clinical trial;  drug use;  follow up;  human;  hypercholesterolemia;  meta analysis;  priority journal;  randomized controlled trial;  risk reduction;  systematic review, Anticarcinogenic Agents;  Chemoprevention;  Clinical Trials;  Colorectal Neoplasms;  Female;  Humans;  Hydroxymethylglutaryl-CoA Reductase Inhibitors;  Hypercholesterolemia;  Male;  Risk;  Treatment Outcome
TODO - Purpose: Statins have been suggested to prevent colorectal cancer. Several epidemiologic studies have evaluated this association, whereas randomized controlled trials (RCTs) on cardiovascular outcomes provide relevant data as a secondary end point. Our aim was to examine the strength of this association through a detailed meta-analysis of the studies published on the subject in peer-reviewed literature. Methods: A comprehensive search for studies published up to December 2006 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 with 95% CIs were calculated using the fixed- and random-effects models. Results: Eighteen studies involving more than 1.5 million participants contributed to the analysis. They were grouped on the basis of study design, and separate meta-analyses were conducted. There was no evidence of an association between statin use and risk of colorectal cancer either among RCTs (RR = 0.95; 95% CI, 0.80 to 1.13; n = 6) or among cohort studies (RR = 0.96; 95% CI, 0.84 to 1.11; n = 3). However, statin use was associated with a modest reduction in the risk of colorectal cancer among case-control studies (RR = 0.91; 95% CI, 0.87 to 0.96; n = 9). Low evidence of publication bias or heterogeneity was found. Conclusion: Our meta-analysis results do not support the hypothesis that statins strongly reduce the risk of colorectal cancer, when taken for management of hypercholesterolemia. However, we cannot rule out a modest reduction in risk or an effect associated with higher doses of statins. © 2007 by American Society of Clinical Oncology.
ER -