TY - JOUR
T1 - Statins are associated with a reduced risk of hepatocellular cancer
T2 - A systematic review and meta-analysis
AU - Singh, Siddharth
AU - Singh, Preet Paul
AU - Singh, Abha Goyal
AU - Murad, Mohammad Hassan
AU - Sanchez, William
PY - 2013/2
Y1 - 2013/2
N2 - BACKGROUND & AIMS: Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality worldwide. Several studies have shown that statins could have chemopreventive effects on HCC. We performed a systematic review and meta-analysis of studies that evaluated the effects of statins on the risk of HCC. METHODS: We conducted a systematic search of MEDLINE, Embase, and Web of Science through May 2012 and manually reviewed the literature. Studies were included if they evaluated and clearly defined exposure to statins, reported the incidence of HCC, and reported relative risks or odds ratios (ORs) or provided data for their estimation. Ten studies reporting 4298 cases of HCC in 1,459,417 patients were analyzed. Summary OR estimates with 95% confidence intervals (CIs) were calculated using the random effects model. Statistical heterogeneity was assessed with the Cochran's Q statistic and I2 statistic. RESULTS: Statin users were less likely to develop HCC than statin nonusers (adjusted OR, 0.63; 95% CI, 0.52- 0.76), although the results were heterogeneous (P = .01, I2 = 59%). This heterogeneity could be accounted for by study location (Asian population [n = 4]: adjusted OR, 0.52; 95% CI, 0.42- 0.64; Western population [n = 6]: adjusted OR, 0.67; 95% CI, 0.53- 0.85) and design (observational studies [n = 7]: adjusted OR, 0.60; 95% CI, 0.49 - 0.73; clinical trials [n = 3]: adjusted OR, 0.95; 95% CI, 0.62- 1.45). CONCLUSIONS: Based on meta-analysis, statin use is associated with a reduced risk of HCC, most strongly in Asian but also in Western populations. Randomized clinical trials in populations at high risk for HCC (especially in Asian populations with hepatitis B) are warranted.
AB - BACKGROUND & AIMS: Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality worldwide. Several studies have shown that statins could have chemopreventive effects on HCC. We performed a systematic review and meta-analysis of studies that evaluated the effects of statins on the risk of HCC. METHODS: We conducted a systematic search of MEDLINE, Embase, and Web of Science through May 2012 and manually reviewed the literature. Studies were included if they evaluated and clearly defined exposure to statins, reported the incidence of HCC, and reported relative risks or odds ratios (ORs) or provided data for their estimation. Ten studies reporting 4298 cases of HCC in 1,459,417 patients were analyzed. Summary OR estimates with 95% confidence intervals (CIs) were calculated using the random effects model. Statistical heterogeneity was assessed with the Cochran's Q statistic and I2 statistic. RESULTS: Statin users were less likely to develop HCC than statin nonusers (adjusted OR, 0.63; 95% CI, 0.52- 0.76), although the results were heterogeneous (P = .01, I2 = 59%). This heterogeneity could be accounted for by study location (Asian population [n = 4]: adjusted OR, 0.52; 95% CI, 0.42- 0.64; Western population [n = 6]: adjusted OR, 0.67; 95% CI, 0.53- 0.85) and design (observational studies [n = 7]: adjusted OR, 0.60; 95% CI, 0.49 - 0.73; clinical trials [n = 3]: adjusted OR, 0.95; 95% CI, 0.62- 1.45). CONCLUSIONS: Based on meta-analysis, statin use is associated with a reduced risk of HCC, most strongly in Asian but also in Western populations. Randomized clinical trials in populations at high risk for HCC (especially in Asian populations with hepatitis B) are warranted.
KW - Cholesterol- lowering drugs
KW - Epidemiology
KW - HMG-CoA reductase inhibitors
KW - Liver cancer prevention
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U2 - 10.1053/j.gastro.2012.10.005
DO - 10.1053/j.gastro.2012.10.005
M3 - Article
C2 - 23063971
AN - SCOPUS:84881491358
SN - 0016-5085
VL - 144
SP - 323
EP - 332
JO - Gastroenterology
JF - Gastroenterology
IS - 2
ER -