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Use of statins and breast cancer: a meta-analysis of seven randomized clinical trials and nine observational studies.
J Clin Oncol. 2005 Dec 01; 23(34):8606-12.JC

Abstract

PURPOSE

A growing body of evidence suggests that statins may have chemopreventive potential against breast cancer. Laboratory studies demonstrate that statins induce apoptosis and reduce cell invasiveness in various cell lines, including breast carcinoma cells. However, the clinical relevance of these data remains unclear. The nonconclusive nature of the epidemiologic data prompted us to conduct a detailed meta-analysis of the studies published on the subject in peer-reviewed literature.

PATIENTS AND METHODS

A comprehensive search for articles published up until 2005 was performed; reviews of each study were conducted; and data were abstracted. Before meta-analysis, the studies were evaluated for publication bias and heterogeneity. Pooled relative risk (RR) estimates and 95% CIs were calculated using the random and the fixed-effects models. Subgroup and sensitivity analyses were also performed.

RESULTS

Seven large randomized trials and nine observational studies (five case-control and four cohort studies) contributed to the analysis. We found no evidence of publication bias or heterogeneity among the studies. Statin use did not significantly affect breast cancer risk (fixed effects model: RR = 1.03; 95% CI, 0.93 to 1.14; random effects model: RR = 1.02; 95% CI, 0.89 to 1.18). When the analyses were stratified into subgroups, there was no evidence that study design substantially influenced the estimate of effects. Furthermore, the sensitivity analysis confirmed the stability of our results.

CONCLUSION

Our meta-analysis findings do not support a protective effect of statins against breast cancer. However, this conclusion is limited by the relatively short follow-up times of the studies analyzed. Further studies are required to investigate the potential decrease in breast cancer risk among long-term statin users.

Authors+Show Affiliations

Department of Pharmacology, School of Medicine, University of Athens, 75 Mikras Asias Str, Athens 11527, Greece. sbonovas@med.uoa.grNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis

Language

eng

PubMed ID

16260694

Citation

Bonovas, Stefanos, et al. "Use of Statins and Breast Cancer: a Meta-analysis of Seven Randomized Clinical Trials and Nine Observational Studies." Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, vol. 23, no. 34, 2005, pp. 8606-12.
Bonovas S, Filioussi K, Tsavaris N, et al. Use of statins and breast cancer: a meta-analysis of seven randomized clinical trials and nine observational studies. J Clin Oncol. 2005;23(34):8606-12.
Bonovas, S., Filioussi, K., Tsavaris, N., & Sitaras, N. M. (2005). Use of statins and breast cancer: a meta-analysis of seven randomized clinical trials and nine observational studies. Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, 23(34), 8606-12.
Bonovas S, et al. Use of Statins and Breast Cancer: a Meta-analysis of Seven Randomized Clinical Trials and Nine Observational Studies. J Clin Oncol. 2005 Dec 1;23(34):8606-12. PubMed PMID: 16260694.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of statins and breast cancer: a meta-analysis of seven randomized clinical trials and nine observational studies. AU - Bonovas,Stefanos, AU - Filioussi,Kalitsa, AU - Tsavaris,Nikolaos, AU - Sitaras,Nikolaos M, Y1 - 2005/10/31/ PY - 2005/11/2/pubmed PY - 2006/2/14/medline PY - 2005/11/2/entrez SP - 8606 EP - 12 JF - Journal of clinical oncology : official journal of the American Society of Clinical Oncology JO - J. Clin. Oncol. VL - 23 IS - 34 N2 - PURPOSE: A growing body of evidence suggests that statins may have chemopreventive potential against breast cancer. Laboratory studies demonstrate that statins induce apoptosis and reduce cell invasiveness in various cell lines, including breast carcinoma cells. However, the clinical relevance of these data remains unclear. The nonconclusive nature of the epidemiologic data prompted us to conduct a detailed meta-analysis of the studies published on the subject in peer-reviewed literature. PATIENTS AND METHODS: A comprehensive search for articles published up until 2005 was performed; reviews of each study were conducted; and data were abstracted. Before meta-analysis, the studies were evaluated for publication bias and heterogeneity. Pooled relative risk (RR) estimates and 95% CIs were calculated using the random and the fixed-effects models. Subgroup and sensitivity analyses were also performed. RESULTS: Seven large randomized trials and nine observational studies (five case-control and four cohort studies) contributed to the analysis. We found no evidence of publication bias or heterogeneity among the studies. Statin use did not significantly affect breast cancer risk (fixed effects model: RR = 1.03; 95% CI, 0.93 to 1.14; random effects model: RR = 1.02; 95% CI, 0.89 to 1.18). When the analyses were stratified into subgroups, there was no evidence that study design substantially influenced the estimate of effects. Furthermore, the sensitivity analysis confirmed the stability of our results. CONCLUSION: Our meta-analysis findings do not support a protective effect of statins against breast cancer. However, this conclusion is limited by the relatively short follow-up times of the studies analyzed. Further studies are required to investigate the potential decrease in breast cancer risk among long-term statin users. SN - 0732-183X UR - https://www.unboundmedicine.com/medline/citation/16260694/Use_of_statins_and_breast_cancer:_a_meta_analysis_of_seven_randomized_clinical_trials_and_nine_observational_studies_ L2 - http://ascopubs.org/doi/full/10.1200/JCO.2005.02.7045?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -