Multimedialna platforma wiedzy medycznej Internetowa Księgarnia Medyczna Kalendarium Konferencji
Cardiology Journal
MENU
Shortcuts Submit an article CJ Guide for Authors (new) Recent articles Special collections Ahead Of Print APIS-S Online Calculator OCT Contrast Calculator Reviewers 2022

open access

Ahead of print
Original Article
Submitted: 2022-02-18
Accepted: 2022-02-25
Published online: 2022-03-22
View PDF Download PDF file Supp./Additional Files [1]
Get Citation

Statins and the risk of pancreatic cancer: A systematic review and meta-analysis of 2,797,186 patients

Eryka Karbowska1, Damian Swieczkowski2, Aleksandra Gasecka3, Michal Pruc4, Kamil Safiejko5, Jerzy R. Ladny6, Tomasz Kopiec3, Milosz J. Jaguszewski7, Krzysztof J. Filipiak8, Zubaid Rafique9, Lukasz Szarpak10119
DOI: 10.5603/CJ.a2022.0014
·
Pubmed: 35373328
Affiliations
  1. Department of CT and MR Radiology, Maria Sklodowska-Curie Bialystok Oncology Center, Bialystok, Poland
  2. Department of Toxicology, Faculty of Pharmacy, Medical University of Gdansk, Gdańsk, Poland;
  3. First Chair and Department of Cardiology, Medical University of Warsaw, Poland
  4. Research Unit, Polish Soceity of Disaster Medicine, Warsaw, Poland
  5. Colorectal Cancer Unit, Maria Sklodowska-Curie Bialystok Oncology Center, Bialystok, Poland;
  6. Department of Emergency Medicine, Medical University of Bialystok, Bialystok, Poland
  7. 1st Department of Cardiology, Medical University of Gdansk, Gdansk, Poland
  8. Institute of Clinical Science, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland;
  9. Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, USA;
  10. Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland
  11. Research Unit, Maria Sklodowska-Curie Bialystok Oncology Center, Bialystok, Poland

open access

Ahead of print
Original articles
Submitted: 2022-02-18
Accepted: 2022-02-25
Published online: 2022-03-22

Abstract

Background: Statin use in many studies is related to the improvement of a patients’ condition including reducing the risk of various malignancies. Herein, is a systematic review and meta-analysis to examine the evidence on the association between statin therapy and the risk of the occurrence of pancreatic cancer, mainly in terms of decreased risk of developing pancreatic cancer among patients using statin therapy in the long-term perspective.

Methods: PubMed, Web of Science, Scopus and Cochrane Central Register of Controlled Trials (CENTRAL) were searched from database inception to December 1st, 2021. Random effect models were used to estimate summary odds ratios (OR) and the corresponding 95% confidence intervals (CI).

Results: A total of 26 studies comprising 2,797,186 patients were included. Polled analysis showed that pancreatic cancer occurrence in statin vs. no-statin group varied and amounted to 0.4% vs. 0.6% (RR = 0.83; 95% CI: 0.72–0.96; I2 = 84%; p = 0.01).

Conclusions: In summary, the present analysis shows that overall statins use is significantly associated with a reduction in risk of pancreatic cancer. However, these results were not confirmed for the randomized controlled trial subgroup. Further prospective studies are needed to confirm the current results.

Abstract

Background: Statin use in many studies is related to the improvement of a patients’ condition including reducing the risk of various malignancies. Herein, is a systematic review and meta-analysis to examine the evidence on the association between statin therapy and the risk of the occurrence of pancreatic cancer, mainly in terms of decreased risk of developing pancreatic cancer among patients using statin therapy in the long-term perspective.

Methods: PubMed, Web of Science, Scopus and Cochrane Central Register of Controlled Trials (CENTRAL) were searched from database inception to December 1st, 2021. Random effect models were used to estimate summary odds ratios (OR) and the corresponding 95% confidence intervals (CI).

Results: A total of 26 studies comprising 2,797,186 patients were included. Polled analysis showed that pancreatic cancer occurrence in statin vs. no-statin group varied and amounted to 0.4% vs. 0.6% (RR = 0.83; 95% CI: 0.72–0.96; I2 = 84%; p = 0.01).

Conclusions: In summary, the present analysis shows that overall statins use is significantly associated with a reduction in risk of pancreatic cancer. However, these results were not confirmed for the randomized controlled trial subgroup. Further prospective studies are needed to confirm the current results.

Full Text:

View PDF Download PDF file Supp./Additional Files [1]
Get Citation

Keywords

pancreatic cancer, pancreatic malignancy, statin, risk, systematic review, meta-analysis

Supp./Additional Files (1)
Supplementary file
Download
1MB
About this article
Title

Statins and the risk of pancreatic cancer: A systematic review and meta-analysis of 2,797,186 patients

Journal

Cardiology Journal

Issue

Ahead of print

Article type

Original Article

Published online

2022-03-22

Page views

1839

Article views/downloads

632

DOI

10.5603/CJ.a2022.0014

Pubmed

35373328

Keywords

pancreatic cancer
pancreatic malignancy
statin
risk
systematic review
meta-analysis

Authors

Eryka Karbowska
Damian Swieczkowski
Aleksandra Gasecka
Michal Pruc
Kamil Safiejko
Jerzy R. Ladny
Tomasz Kopiec
Milosz J. Jaguszewski
Krzysztof J. Filipiak
Zubaid Rafique
Lukasz Szarpak

References (57)
  1. Ilic M, Ilic I. Epidemiology of pancreatic cancer. World J Gastroenterol. 2016; 22: 9694–9705.
    CrossRefPubMed
  2. Ansari D, Tingstedt B, Andersson B, et al. Pancreatic cancer: yesterday, today and tomorrow. Future Oncol. 2016; 12(16): 1929–1946.
    CrossRefPubMed
  3. Torphy RJ, Fujiwara Y, Schulick RD. Pancreatic cancer treatment: better, but a long way to go. Surg Today. 2020; 50(10): 1117–1125.
    CrossRefPubMed
  4. Goggins M, Overbeek KA, Brand R, et al. Management of patients with increased risk for familial pancreatic cancer: updated recommendations from the International Cancer of the Pancreas Screening (CAPS) Consortium. Gut. 2020; 69(1): 7–17.
    CrossRefPubMed
  5. McGuigan A, Kelly P, Turkington RC, et al. Pancreatic cancer: A review of clinical diagnosis, epidemiology, treatment and outcomes. World J Gastroenterol. 2018; 24(43): 4846–4861.
    CrossRefPubMed
  6. Jiang MJ, Dai JJ, Gu DN, et al. Aspirin in pancreatic cancer: chemopreventive effects and therapeutic potentials. Biochim Biophys Acta. 2016; 1866(2): 163–176.
    CrossRefPubMed
  7. Sun J, Li Y, Liu L, et al. Aspirin use and pancreatic cancer risk: A systematic review of observational studies. Medicine (Baltimore). 2019; 98(51): e18033.
    CrossRefPubMed
  8. Tan XL, Reid Lombardo KM, Bamlet WR, et al. Aspirin, nonsteroidal anti-inflammatory drugs, acetaminophen, and pancreatic cancer risk: a clinic-based case-control study. Cancer Prev Res (Phila). 2011; 4(11): 1835–1841.
    CrossRefPubMed
  9. Li D, Ma Y, Liu W, et al. Celecoxib combined with salirasib strongly inhibits pancreatic cancer cells in 2D and 3D cultures. Int J Med Sci. 2020; 17(12): 1795–1802.
    CrossRefPubMed
  10. Kho PF, Fawcett J, Fritschi L, et al. Nonsteroidal anti-inflammatory drugs, statins, and pancreatic cancer risk: a population-based case-control study. Cancer Causes Control. 2016; 27(12): 1457–1464.
    CrossRefPubMed
  11. Lai SW, Kuo YH, Liao KF. Statins and pancreatic cancer risk. J Gastroenterol. 2020; 55(4): 471–472.
    CrossRefPubMed
  12. Carrer A, Trefely S, Zhao S, et al. Acetyl-CoA metabolism supports multistep pancreatic tumorigenesis. Cancer Discov. 2019; 9(3): 416–435.
    CrossRefPubMed
  13. Gong J, Sachdev E, Robbins LA, et al. Statins and pancreatic cancer. Oncol Lett. 2017; 13(3): 1035–1040.
    CrossRefPubMed
  14. Lee HS, Lee SH, Lee HJ, et al. Statin use and its impact on survival in pancreatic cancer patients. Medicine (Baltimore). 2016; 95(19): e3607.
    CrossRefPubMed
  15. Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Syst Rev. 2021; 10(1): 89.
    CrossRefPubMed
  16. Sterne JAC, Savović J, Page MJ, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019; 366: l4898.
    CrossRefPubMed
  17. Sterne JAc, Hernán MA, Reeves BC, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016; 355: i4919.
    CrossRefPubMed
  18. McGuinness LA, Higgins JPT. Risk-of-bias VISualization (robvis): An R package and Shiny web app for visualizing risk-of-bias assessments. Res Synth Methods. 2021; 12(1): 55–61.
    CrossRefPubMed
  19. Higgins JPT, Thompson SG, Deeks JJ, et al. Measuring inconsistency in meta-analyses. BMJ. 2003; 327(7414): 557–560.
    CrossRefPubMed
  20. Archibugi L, Piciucchi M, Stigliano S, et al. Exclusive and combined use of statins and aspirin and the risk of pancreatic cancer: a case-control study. Sci Rep. 2017; 7(1): 13024.
    CrossRefPubMed
  21. Bang UC, Watanabe T, Bendtsen F. The relationship between the use of statins and mortality, severity, and pancreatic cancer in Danish patients with chronic pancreatitis. Eur J Gastroenterol Hepatol. 2018; 30(3): 346–351.
    CrossRefPubMed
  22. Bradley MC, Hughes CM, Cantwell MM, et al. Statins and pancreatic cancer risk: a nested case-control study. Cancer Causes Control. 2010; 21(12): 2093–2100.
    CrossRefPubMed
  23. Carey FJ, Little MW, Pugh TFG, et al. The differential effects of statins on the risk of developing pancreatic cancer: a case-control study in two centres in the United Kingdom. Dig Dis Sci. 2013; 58(11): 3308–3312.
    CrossRefPubMed
  24. Chen MJ, Tsan YT, Liou JM, et al. Statins and the risk of pancreatic cancer in Type 2 diabetic patients--A population-based cohort study. Int J Cancer. 2016; 138(3): 594–603.
    CrossRefPubMed
  25. Chiu HF, Chang CC, Ho SC, et al. Statin use and the risk of pancreatic cancer: a population-based case-control study. Pancreas. 2011; 40(5): 669–672.
    CrossRefPubMed
  26. Clearfield M, Downs JR, Weis S, et al. Air Force/Texas Coronary Atherosclerosis Prevention Study (AFCAPS/TexCAPS): efficacy and tolerability of long-term treatment with lovastatin in women. J Womens Health Gend Based Med. 2001; 10(10): 971–981.
    CrossRefPubMed
  27. Coogan PF, Rosenberg L, Strom BL. Statin use and the risk of 10 cancers. Epidemiology. 2007; 18(2): 213–219.
    CrossRefPubMed
  28. Graaf MR, Beiderbeck AB, Egberts ACG, et al. The risk of cancer in users of statins. J Clin Oncol. 2004; 22(12): 2388–2394.
    CrossRefPubMed
  29. Haukka J, Sankila R, Klaukka T, et al. Incidence of cancer and statin usage--record linkage study. Int J Cancer. 2010; 126(1): 279–284.
    CrossRefPubMed
  30. Jacobs EJ, Newton CC, Thun MJ, et al. Long-term use of cholesterol-lowering drugs and cancer incidence in a large United States cohort. Cancer Res. 2011; 71(5): 1763–1771.
    CrossRefPubMed
  31. Kabat GC, Kim MY, Chlebowski RT, et al. Serum lipids and risk of obesity-related cancers in postmenopausal women. Cancer Causes Control. 2018; 29(1): 13–24.
    CrossRefPubMed
  32. Karp I, Behlouli H, Lelorier J, et al. Statins and cancer risk. Am J Med. 2008; 121(4): 302–309.
    CrossRefPubMed
  33. Kaye JA, Jick H. Statin use and cancer risk in the General Practice Research Database. Br J Cancer. 2004; 90(3): 635–637.
    CrossRefPubMed
  34. Khurana V, Sheth A, Caldito G, et al. Statins reduce the risk of pancreatic cancer in humans: a case-control study of half a million veterans. Pancreas. 2007; 34(2): 260–265.
    CrossRefPubMed
  35. Kirkegård J, Lund JL, Mortensen FV, et al. Statins and pancreatic cancer risk in patients with chronic pancreatitis: A Danish nationwide population-based cohort study. Int J Cancer. 2020; 146(3): 610–616.
    CrossRefPubMed
  36. Leung HWC, Chan ALF, Lo D, et al. Common cancer risk and statins: a population-based case-control study in a Chinese population. Expert Opin Drug Saf. 2013; 12(1): 19–27.
    CrossRefPubMed
  37. Marelli C, Gunnarsson C, Ross S, et al. Statins and risk of cancer: a retrospective cohort analysis of 45,857 matched pairs from an electronic medical records database of 11 million adult Americans. J Am Coll Cardiol. 2011; 58(5): 530–537.
    CrossRefPubMed
  38. Peto R, Emberson J, Landray M, et al. Analyses of cancer data from three ezetimibe trials. N Engl J Med. 2008; 359(13): 1357–1366.
    CrossRefPubMed
  39. Sato S, Ajiki W, Kobayashi T, et al. PCS Study Group. Pravastatin use and the five-year incidence of cancer in coronary heart disease patients: from the prevention of coronary sclerosis study. J Epidemiol. 2006; 16(5): 201–206.
    CrossRefPubMed
  40. Serruys PW, de Feyter P, Macaya C, et al. Fluvastatin for prevention of cardiac events following successful first percutaneous coronary intervention: a randomized controlled trial. JAMA. 2002; 287(24): 3215–3222.
    CrossRefPubMed
  41. Simon MS, Desai P, Wallace R, et al. Prospective analysis of association between statins and pancreatic cancer risk in the Women's Health Initiative. Cancer Causes Control. 2016; 27(3): 415–423.
    CrossRefPubMed
  42. Strandberg T, Pyörälä K, Cook T, et al. Mortality and incidence of cancer during 10-year follow-up of the Scandinavian Simvastatin Survival Study (4S). The Lancet. 2004; 364(9436): 771–777.
    CrossRefPubMed
  43. Vinogradova Y, Coupland C, Hippisley-Cox J. Exposure to statins and risk of common cancers: a series of nested case-control studies. BMC Cancer. 2011; 11: 409.
    CrossRefPubMed
  44. Walker EJ, Ko AH, Holly EA, et al. Statin use and risk of pancreatic cancer: results from a large, clinic-based case-control study. Cancer. 2015; 121(8): 1287–1294.
    CrossRefPubMed
  45. Zhang Y, Liang M, Sun C, et al. Statin use and risk of pancreatic cancer: an updated meta-analysis of 26 studies. Pancreas. 2019; 48(2): 142–150.
    CrossRefPubMed
  46. Kawada T. Statin use and pancreatic cancer: A risk assessment. Dig Liver Dis. 2019; 51(5): 749.
    CrossRefPubMed
  47. Archibugi L, Arcidiacono PG, Capurso G. Statin use is associated to a reduced risk of pancreatic cancer: A meta-analysis. Dig Liver Dis. 2019; 51(1): 28–37.
    CrossRefPubMed
  48. Bonovas S, Filioussi K, Sitaras NM. Statins are not associated with a reduced risk of pancreatic cancer at the population level, when taken at low doses for managing hypercholesterolemia: evidence from a meta-analysis of 12 studies. Am J Gastroenterol. 2008; 103(10): 2646–2651.
    CrossRefPubMed
  49. Archibugi L, Arcidiacono PG, Capurso G. Statin use and pancreatic cancer: a risk assessment. Authors? reply. Dig Liver Dis. 2019; 51(5): 750–751.
    CrossRefPubMed
  50. Jian-Yu E, Graber J, Lu SE, et al. Effect of metformin and statin use on survival in pancreatic cancer patients: a systematic literature review and meta-analysis. Curr Med Chem. 2018; 25(22): 2595–2607.
    CrossRefPubMed
  51. Wang D, Rodriguez EA, Barkin JS, et al. Statin use shows increased overall survival in patients diagnosed with pancreatic cancer: a meta-analysis. Pancreas. 2019; 48(4): e22–e23.
    CrossRefPubMed
  52. Tamburrino D, Crippa S, Partelli S, et al. Statin use improves survival in patients with pancreatic ductal adenocarcinoma: A meta-analysis. Dig Liver Dis. 2020; 52(4): 392–399.
    CrossRefPubMed
  53. Bonovas S, Filioussi K, Sitaras N. Statins are not associated with a reduced risk of pancreatic cancer at the population level, when taken at low doses for managing hypercholesterolemia: evidence from a meta-analysis of 12 studies. Am J Gas-troenterol. 2008; 103(10): 2646–2651.
    CrossRefPubMed
  54. Jian-Yu E, Graber J, Lu SE, et al. Effect of metformin and statin use on survival in pancreatic cancer patients: a systematic literature review and meta-analysis. Curr Med Chem. 2018; 25(22): 2595–2607.
    CrossRefPubMed
  55. Gu Y, Yang X, Liang H, et al. Comprehensive evaluation of effects and safety of statin on the progression of liver cirrhosis: a systematic review and meta-analysis. BMC Gastroenterol. 2019; 19(1): 231.
    CrossRefPubMed
  56. Støer NC, Bouche G, Pantziarka P, et al. Use of non-cancer drugs and survival among patients with pancreatic adenocarcinoma: a nationwide registry-based study in Norway. Acta Oncol. 2021; 60(9): 1146–1153.
    CrossRefPubMed
  57. Saito K, Sato Y, Nakatani E, et al. Statin exposure and pancreatic cancer incidence: a Japanese regional population-based cohort study, the Shizuoka study. Cancer Prev Res (Phila). 2021; 14(9): 863–872.
    CrossRefPubMed

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Group sp. z o.o., Grupa Via Medica, ul. Świętokrzyska 73, 80–180 Gdańsk, Poland
tel.:+48 58 320 94 94, fax:+48 58 320 94 60, e-mail: viamedica@viamedica.pl