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

dc.contributor.authorEmberson, J. R.
dc.contributor.authorKearney, Patricia M.
dc.contributor.authorBlackwell, L.
dc.contributor.authorNewman, C.
dc.contributor.authorReith, C.
dc.contributor.authorBhala, N.
dc.contributor.authorHolland, L.
dc.contributor.authorPeto, R.
dc.contributor.authorKeech, A.
dc.contributor.authorCollins, R.
dc.contributor.authorSimes, J.
dc.contributor.authorBaigent, C.
dc.contributor.funderNational Health and Medical Research Council Clinical Trials Centre (CTC), Australiaen
dc.contributor.funderThe Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), United Kingdomen
dc.contributor.funderMedical Research Council, United Kingdomen
dc.contributor.funderBritish Heart Foundation, United Kingdomen
dc.contributor.funderCancer Research, United Kingdomen
dc.contributor.funderEuropean Commissionen
dc.contributor.funderNational Health, Australiaen
dc.contributor.funderMedical Research Council, Australiaen
dc.contributor.funderNational Heart Foundation, Australiaen
dc.contributor.funderBHF Centre of Research Excellence, Oxforden
dc.contributor.funderAstra Zeneca, United Statesen
dc.contributor.funderBristol-Myers Squibb, United Statesen
dc.contributor.funderMerck, United Statesen
dc.contributor.funderNovartis, Switzerlanden
dc.contributor.funderPfizer Pharmaceuticals, United States.en
dc.description.abstractBackground: 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.sponsorshipThe 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.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.identifier.citationEmberson, 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.
dc.identifier.endpagee29849 (10)en
dc.identifier.journaltitlePlos Oneen
dc.identifier.startpagee29849 (1)en
dc.publisherPublic Library of Scienceen
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.subjectCancer treatmenten
dc.subjectDeath ratesen
dc.subjectGastrointestinal cancersen
dc.subjectCancer detectionen
dc.subjectCancer diagnosisen
dc.titleLack of effect of lowering LDL cholesterol on cancer: meta-analysis of individual data from 175,000 people in 27 randomised trials of statin therapyen
dc.typeArticle (peer-reviewed)en
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