Statins and the risk of colorectal cancer: A meta-analysis of 18 studies involving more than 1.5 million patients
Statins and the risk of colorectal cancer: A meta-analysis of 18 studies involving more than 1.5 million patients
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DOI：
10.1200/jco.2007.10.8936
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发表时间：
2007-08-10
影响因子：
45.3
通讯作者：
Sitaras, Nikolaos M.
中科院分区：
文献类型：
--
作者：
Bonovas, Stefanos;Filioussi, Kalitsa;Sitaras, Nikolaos M.
目的他汀类药物被认为可以预防结直肠癌。一些流行病学研究已经评估了这种关联，而关于心血管结局的随机对照试验（RCT）提供了相关数据作为次要终点。我们的目的是检查这种关联的强度，通过一个详细的荟萃分析发表在同行评议literature.Methods的主题上的研究发表到2006年12月的研究进行了全面的搜索，每个研究进行了审查，数据进行了摘要。在进行荟萃分析之前，对研究的发表偏倚和异质性进行了评价。合并相对危险度（RR）估计与95%Cls计算使用的固定和随机效应models.Results 18项研究，涉及超过150万参与者的分析。根据研究设计对他们进行分组，并进行单独的荟萃分析。在随机对照试验（RR = 0.95; 95%CI，0.80 - 1.13; n = 6）或队列研究（RR = 0.96; 95%CI，0.84 - 1.11; n = 3）中，没有证据表明他汀类药物使用与结直肠癌风险之间存在关联。然而，在病例对照研究中，他汀类药物的使用与结直肠癌风险的适度降低相关（RR = 0.91; 95%CI，0.87 - 0.96; n = 9）。发表偏倚或异质性的证据低found.Conclusion我们的荟萃分析结果不支持假设，他汀类药物强烈降低结直肠癌的风险，当采取高胆固醇血症的管理。然而，我们不能排除风险的适度降低或与更高剂量的他汀类药物相关的影响。
Purpose Statins have been suggested to prevent colorectal cancer. Several epidemiologic studies have evaluated this association, whereas randomized controlled trials (RCTs) on cardiovascular outcomes provide relevant data as a secondary end point. Our aim was to examine the strength of this association through a detailed meta-analysis of the studies published on the subject in peer-reviewed literature.Methods A comprehensive search for studies published up to December 2006 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 with 95% Cls were calculated using the fixed-and random-effects models.Results Eighteen studies involving more than 1.5 million participants contributed to the analysis. They were grouped on the basis of study design, and separate meta-analyses were conducted. There was no evidence of an association between statin use and risk of colorectal cancer either among RCTs (RR = 0.95; 95% Cl, 0.80 to 1.13; n = 6) or among cohort studies (RR = 0.96; 95% Cl, 0.84 to 1.11; n = 3). However, statin use was associated with a modest reduction in the risk of colorectal cancer among case-control studies (RR = 0.91; 95% Cl, 0.87 to 0.96; n = 9). Low evidence of publication bias or heterogeneity was found.Conclusion Our meta-analysis results do not support the hypothesis that statins strongly reduce the risk of colorectal cancer, when taken for management of hypercholesterolemia. However, we cannot rule out a modest reduction in risk or an effect associated with higher doses of statins.