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Statins and the risk of lung cancer: a meta-analysis.

Tan M, Song X, Zhang G, Peng A, Li X, Li M, Liu Y, Wang C - PLoS ONE (2013)

Bottom Line: Study-specific risk estimates were pooled using a random-effects model.Low evidence of publication bias was found.However, statistically significant heterogeneity was found among cohort studies and among case-control studies.

View Article: PubMed Central - PubMed

Affiliation: Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China.

ABSTRACT

Purpose: Several epidemiologic studies have evaluated the association between statins and lung cancer risk, whereas randomized controlled trials (RCTs) on cardiovascular outcomes provide relevant data as a secondary end point. We conducted a meta-analysis of all relevant studies to examine this association.

Methods: A systematic literature search up to March 2012 was performed in PubMed database. Study-specific risk estimates were pooled using a random-effects model.

Results: Nineteen studies (5 RCTs and 14 observational studies) involving 38,013 lung cancer cases 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 lung cancer either among RCTs (relative risk [RR] 0.91, 95% confidence interval [CI] 0.76-1.09), among cohort studies (RR 0.94, 95% CI 0.82-1.07), or among case-control studies (RR 0.82, 95% CI 0.57-1.16). Low evidence of publication bias was found. However, statistically significant heterogeneity was found among cohort studies and among case-control studies. After excluding the studies contributing most to the heterogeneity, summary estimates were essentially unchanged.

Conclusion: The results of our meta-analysis suggest that there is no association between statin use and the risk of lung cancer.

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Related in: MedlinePlus

In RCT studies, risk estimates of lung cancer associated with statin use.Squares indicate study-specific risk estimates (size of the square reflects the study-specific statistical weight, i.e., the inverse of the variance); horizontal lines indicate 95% confidence intervals (CIs); diamonds indicate summary risk estimate with its corresponding 95% confidence interval. Abbreviations: RR, risk ratio; AFCAPS, Air Force/Texas Coronary Atherosclerosis Prevention Study; ALLHAT-LLT, Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial; LIPS, Lesol Intervention Prevention; 4S, Scandinavian Simvastatin Survival Study; HPS, Heart Protection Study; WOSCOPS, West of Scotland Coronary Prevention Study.
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pone-0057349-g002: In RCT studies, risk estimates of lung cancer associated with statin use.Squares indicate study-specific risk estimates (size of the square reflects the study-specific statistical weight, i.e., the inverse of the variance); horizontal lines indicate 95% confidence intervals (CIs); diamonds indicate summary risk estimate with its corresponding 95% confidence interval. Abbreviations: RR, risk ratio; AFCAPS, Air Force/Texas Coronary Atherosclerosis Prevention Study; ALLHAT-LLT, Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial; LIPS, Lesol Intervention Prevention; 4S, Scandinavian Simvastatin Survival Study; HPS, Heart Protection Study; WOSCOPS, West of Scotland Coronary Prevention Study.

Mentions: Five RCTs contributed to the analysis [27]–[31]. A total 29,658 individuals participated in these trials: 14,830 in treatment groups and 14,828 in control groups (Table 1). The participants had a mean follow-up of approximately 5.8 years. The overall rate of lung cancer was 1.46% in the statin group (217 incident cases) and 1.61% in the control group (238 incident cases). Figure 2 graphs the RR estimates and 95% CI from the individual trials and the pooled results. Statin use was not found to be associated with the risk of lung cancer (RR 0.91, 95% CI 0.76–1.09). The Cochran’s Q test resulted in a P  =  0.63 (Q  =  2.57), and the corresponding quantity I2 was 0%, both indicating that study results were homogeneous. The P value for the Egger test was P  =  0.30, suggesting a low probability of publication bias.


Statins and the risk of lung cancer: a meta-analysis.

Tan M, Song X, Zhang G, Peng A, Li X, Li M, Liu Y, Wang C - PLoS ONE (2013)

In RCT studies, risk estimates of lung cancer associated with statin use.Squares indicate study-specific risk estimates (size of the square reflects the study-specific statistical weight, i.e., the inverse of the variance); horizontal lines indicate 95% confidence intervals (CIs); diamonds indicate summary risk estimate with its corresponding 95% confidence interval. Abbreviations: RR, risk ratio; AFCAPS, Air Force/Texas Coronary Atherosclerosis Prevention Study; ALLHAT-LLT, Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial; LIPS, Lesol Intervention Prevention; 4S, Scandinavian Simvastatin Survival Study; HPS, Heart Protection Study; WOSCOPS, West of Scotland Coronary Prevention Study.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3585354&req=5

pone-0057349-g002: In RCT studies, risk estimates of lung cancer associated with statin use.Squares indicate study-specific risk estimates (size of the square reflects the study-specific statistical weight, i.e., the inverse of the variance); horizontal lines indicate 95% confidence intervals (CIs); diamonds indicate summary risk estimate with its corresponding 95% confidence interval. Abbreviations: RR, risk ratio; AFCAPS, Air Force/Texas Coronary Atherosclerosis Prevention Study; ALLHAT-LLT, Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial; LIPS, Lesol Intervention Prevention; 4S, Scandinavian Simvastatin Survival Study; HPS, Heart Protection Study; WOSCOPS, West of Scotland Coronary Prevention Study.
Mentions: Five RCTs contributed to the analysis [27]–[31]. A total 29,658 individuals participated in these trials: 14,830 in treatment groups and 14,828 in control groups (Table 1). The participants had a mean follow-up of approximately 5.8 years. The overall rate of lung cancer was 1.46% in the statin group (217 incident cases) and 1.61% in the control group (238 incident cases). Figure 2 graphs the RR estimates and 95% CI from the individual trials and the pooled results. Statin use was not found to be associated with the risk of lung cancer (RR 0.91, 95% CI 0.76–1.09). The Cochran’s Q test resulted in a P  =  0.63 (Q  =  2.57), and the corresponding quantity I2 was 0%, both indicating that study results were homogeneous. The P value for the Egger test was P  =  0.30, suggesting a low probability of publication bias.

Bottom Line: Study-specific risk estimates were pooled using a random-effects model.Low evidence of publication bias was found.However, statistically significant heterogeneity was found among cohort studies and among case-control studies.

View Article: PubMed Central - PubMed

Affiliation: Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China.

ABSTRACT

Purpose: Several epidemiologic studies have evaluated the association between statins and lung cancer risk, whereas randomized controlled trials (RCTs) on cardiovascular outcomes provide relevant data as a secondary end point. We conducted a meta-analysis of all relevant studies to examine this association.

Methods: A systematic literature search up to March 2012 was performed in PubMed database. Study-specific risk estimates were pooled using a random-effects model.

Results: Nineteen studies (5 RCTs and 14 observational studies) involving 38,013 lung cancer cases 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 lung cancer either among RCTs (relative risk [RR] 0.91, 95% confidence interval [CI] 0.76-1.09), among cohort studies (RR 0.94, 95% CI 0.82-1.07), or among case-control studies (RR 0.82, 95% CI 0.57-1.16). Low evidence of publication bias was found. However, statistically significant heterogeneity was found among cohort studies and among case-control studies. After excluding the studies contributing most to the heterogeneity, summary estimates were essentially unchanged.

Conclusion: The results of our meta-analysis suggest that there is no association between statin use and the risk of lung cancer.

Show MeSH
Related in: MedlinePlus