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.
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 pati...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2012-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC3261846?pdf=render |
| _version_ | 1811214231985455104 |
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| author | Cholesterol Treatment Trialists' (CTT) Collaboration Jonathan R Emberson Patricia M Kearney Lisa Blackwell Connie Newman Christina Reith Neeraj Bhala Lisa Holland Richard Peto Anthony Keech Rory Collins John Simes Colin Baigent |
| author_facet | Cholesterol Treatment Trialists' (CTT) Collaboration Jonathan R Emberson Patricia M Kearney Lisa Blackwell Connie Newman Christina Reith Neeraj Bhala Lisa Holland Richard Peto Anthony Keech Rory Collins John Simes Colin Baigent |
| author_sort | Cholesterol Treatment Trialists' (CTT) Collaboration |
| collection | DOAJ |
| description | 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). |
| first_indexed | 2024-04-12T06:00:57Z |
| format | Article |
| id | doaj.art-e122ec327c9541d39f6c21d47da72e42 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-12T06:00:57Z |
| publishDate | 2012-01-01 |
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| spelling | doaj.art-e122ec327c9541d39f6c21d47da72e422022-12-22T03:45:03ZengPublic Library of Science (PLoS)PLoS ONE1932-62032012-01-0171e2984910.1371/journal.pone.0029849Lack of effect of lowering LDL cholesterol on cancer: meta-analysis of individual data from 175,000 people in 27 randomised trials of statin therapy.Cholesterol Treatment Trialists' (CTT) CollaborationJonathan R EmbersonPatricia M KearneyLisa BlackwellConnie NewmanChristina ReithNeeraj BhalaLisa HollandRichard PetoAnthony KeechRory CollinsJohn SimesColin BaigentBACKGROUND: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).http://europepmc.org/articles/PMC3261846?pdf=render |
| spellingShingle | Cholesterol Treatment Trialists' (CTT) Collaboration Jonathan R Emberson Patricia M Kearney Lisa Blackwell Connie Newman Christina Reith Neeraj Bhala Lisa Holland Richard Peto Anthony Keech Rory Collins John Simes Colin Baigent 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 |
| 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. |
| title_full | 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. |
| title_fullStr | 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. |
| title_full_unstemmed | 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. |
| title_short | 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. |
| title_sort | 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 |
| url | http://europepmc.org/articles/PMC3261846?pdf=render |
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