| Abstract
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Background:
We recently reported an inverse association between on-treatment LDL-C
levels and incident cancer in statin-treated patients enrolled in large
randomized controlled trials, raising concern that LDL-C lowering by statins
may increase cancer risk. However, meta-analyses suggest a neutral overall
effect of statins on incident cancer.
Methods: A systematic literature search identified 15 eligible randomized
controlled trials of statins with 1,000 person-years of follow-up that
provided on-treatment LDL-C levels and rates of incident cancers (19 statin
and 14 control arms, 437,017 person-years cumulative follow-up, and 5,752
incident cancers).
Results: In the statin arms, meta-regression analysis demonstrated an
inverse association between on-treatment LDL-C and incident cancer, with
an excess of 2.2 (95% confidence interval: 0.7 to 3.6) cancers per 1,000
person-years for every 10 mg/dl decrement in on-treatment LDL-C (p = 0.006).
The corresponding difference among control arms was 1.2 (95% confidence
interval: –0.2 to 2.7, p = 0.09). Compared with the control arms,
the statin regression line was significantly shifted leftward, such that
similar rates of incident cancer were associated with lower on-treatment
LDL-C (p < 0.05). Meta-regression demonstrated that statins lack an
effect on cancer risk across all levels of on-treatment LDL-C.
Conclusions: There is an inverse association between on-treatment LDL-C
and incident cancer. However, statins, despite producing marked reductions
in LDL-C, are not associated with an increased risk of cancer.
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