Lack of effect of lowering LDL cholesterol on cancer: meta-analysis of individual data from 175,000 people in 27 randomised trials of statin therapy

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dc.contributor.author Emberson, J. R.
dc.contributor.author Kearney, Patricia M.
dc.contributor.author Blackwell, L.
dc.contributor.author Newman, C.
dc.contributor.author Reith, C.
dc.contributor.author Bhala, N.
dc.contributor.author Holland, L.
dc.contributor.author Peto, R.
dc.contributor.author Keech, A.
dc.contributor.author Collins, R.
dc.contributor.author Simes, J.
dc.contributor.author Baigent, C.
dc.date.accessioned 2016-07-12T15:08:37Z
dc.date.available 2016-07-12T15:08:37Z
dc.date.issued 2012-01-19
dc.identifier.citation Emberson, J. R., Kearney, P. M., Blackwell, L., Newman, C., Reith, C., Bhala, N., Holland, L., Peto, R., Keech, A., Collins. R., Simes, J. and Baigent, C (2012) 'Lack of effect of lowering LDL cholesterol on cancer: meta-analysis of individual data from 175,000 people in 27 randomised trials of statin therapy'. Plos One, 7(1): e29849. http://dx.doi.org/10.1371/journal.pone.0029849 en
dc.identifier.volume 7 en
dc.identifier.issued 1 en
dc.identifier.startpage e29849 (1) en
dc.identifier.endpage e29849 (10) en
dc.identifier.issn 1932-6203
dc.identifier.uri http://hdl.handle.net/10468/2860
dc.identifier.doi 10.1371/journal.pone.0029849
dc.description.abstract Background: Statin therapy reduces the risk of occlusive vascular events, but uncertainty remains about potential effects on cancer. We sought to provide a detailed assessment of any effects on cancer of lowering LDL cholesterol (LDL-C) with a statin using individual patient records from 175,000 patients in 27 large-scale statin trials. Methods and Findings: Individual records of 134,537 participants in 22 randomised trials of statin versus control (median duration 4.8 years) and 39,612 participants in 5 trials of more intensive versus less intensive statin therapy (median duration 5.1 years) were obtained. Reducing LDL-C with a statin for about 5 years had no effect on newly diagnosed cancer or on death from such cancers in either the trials of statin versus control (cancer incidence: 3755 [1.4% per year [py]] versus 3738 [1.4% py], RR 1.00 [95% CI 0.96-1.05]; cancer mortality: 1365 [0.5% py] versus 1358 [0.5% py], RR 1.00 [95% CI 0.93-1.08]) or in the trials of more versus less statin (cancer incidence: 1466 [1.6% py] vs 1472 [1.6% py], RR 1.00 [95% CI 0.93-1.07]; cancer mortality: 447 [0.5% py] versus 481 [0.5% py], RR 0.93 [95% CI 0.82-1.06]). Moreover, there was no evidence of any effect of reducing LDL-C with statin therapy on cancer incidence or mortality at any of 23 individual categories of sites, with increasing years of treatment, for any individual statin, or in any given subgroup. In particular, among individuals with low baseline LDL-C (<2 mmol/L), there was no evidence that further LDL-C reduction (from about 1.7 to 1.3 mmol/L) increased cancer risk (381 [1.6% py] versus 408 [1.7% py]; RR 0.92 [99% CI 0.76-1.10]). Conclusions: In 27 randomised trials, a median of five years of statin therapy had no effect on the incidence of, or mortality from, any type of cancer (or the aggregate of all cancer). en
dc.description.sponsorship The Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), UK; National Health and Medical Research Council Clinical Trials Centre (CTC), Australia; Medical Research Council, UK; British Heart Foundation, UK; Cancer Research UK; European Commission (European Community Biomed Programme); Australian National Health, Australia; and Medical Research Council, Australia; National Heart Foundation, Australia; BHF Centre of Research Excellence, Oxford, UK (RE/08/04); Astra Zeneca, United States; Bristol-Myers Squibb, United States; Merck, United States; Novartis, Switzerland; Pfizer Pharmaceuticals, United States. en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Public Library of Science en
dc.rights © 2012 CTT Collaboration. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. en
dc.rights.uri https://creativecommons.org/licenses/by/4.0/legalcode en
dc.subject Cholesterol en
dc.subject Statins en
dc.subject Cancer treatment en
dc.subject Meta-analysis en
dc.subject Death rates en
dc.subject Gastrointestinal cancers en
dc.subject Cancer detection en
dc.subject Cancer diagnosis en
dc.subject Lipids en
dc.title Lack of effect of lowering LDL cholesterol on cancer: meta-analysis of individual data from 175,000 people in 27 randomised trials of statin therapy en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Patricia M. Kearney, Epidemiology & Public Health, University College Cork, Cork, Ireland. +353-21-490-3000 Email: patricia.kearney@ucc.ie Remove selected en
dc.internal.availability Full text available en
dc.date.updated 2013-11-28T14:56:52Z
dc.description.version Published Version en
dc.internal.rssid 221089828
dc.internal.pmid 22276132
dc.contributor.funder National Health and Medical Research Council Clinical Trials Centre (CTC), Australia en
dc.contributor.funder The Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), United Kingdom en
dc.contributor.funder Medical Research Council, United Kingdom en
dc.contributor.funder British Heart Foundation, United Kingdom en
dc.contributor.funder Cancer Research, United Kingdom en
dc.contributor.funder European Commission en
dc.contributor.funder National Health, Australia en
dc.contributor.funder Medical Research Council, Australia en
dc.contributor.funder National Heart Foundation, Australia en
dc.contributor.funder BHF Centre of Research Excellence, Oxford en
dc.contributor.funder Astra Zeneca, United States en
dc.contributor.funder Bristol-Myers Squibb, United States en
dc.contributor.funder Merck, United States en
dc.contributor.funder Novartis, Switzerland en
dc.contributor.funder Pfizer Pharmaceuticals, United States. en
dc.description.status Peer reviewed en
dc.identifier.journaltitle Plos One en
dc.internal.copyrightchecked Yes. !!CORA!! en
dc.internal.licenseacceptance Yes en
dc.internal.IRISemailaddress patricia.kearney@ucc.ie en
dc.identifier.articleid e29849


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© 2012 CTT Collaboration. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Except where otherwise noted, this item's license is described as © 2012 CTT Collaboration. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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