Statin use and the risk of prostate cancer: A metaanalysis of 6 randomized clinical trials and 13 observational studies
Statin use and the risk of prostate cancer: A metaanalysis of 6 randomized clinical trials and 13 observational studies
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DOI：
10.1002/ijc.23550
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发表时间：
2008-08-15
影响因子：
6.4
通讯作者：
Sitaras, Nikolaus M.
中科院分区：
文献类型：
--
作者：
Bonovas, Stefanos;Filioussi, Kalitsa;Sitaras, Nikolaus M.
他汀类药物已被建议用于预防前列腺癌。我们的目的是通过对同行评议文献中发表的流行病学研究进行详细的荟萃分析，检查他汀类药物在整个前列腺癌和临床上更重要的晚期前列腺癌中的使用情况。对截至2007年11月发表的文章进行全面搜索，对每项研究进行审查，并提取数据。在荟萃分析之前，对这些研究的发表偏倚和异质性进行了评估。采用随机效应模型计算合并相对危险度(RR)和95%可信区间(CI)。同时进行亚组分析和敏感性分析。19项研究[6项随机临床试验(RCT)，6项队列研究和7项病例对照研究]参与了分析。在随机对照试验(RR=1.06，95%CI：0.93-1.20)或观察性研究(RR=0.89，95%CI：0.65-1.24)中，没有证据表明他汀类药物的使用与总前列腺癌之间存在关联。然而，在观察性研究中发现了高度的异质性。此外，长期使用他汀类药物对总前列腺癌的风险没有显著影响(RR=0.93，95%CI：0.77-1.13)。相反，综合专门研究他汀类药物使用与晚期前列腺癌相关的现有报告，表明两者之间存在保护性关联(RR=0.77，95%CI：0.64-0.93)。我们的结果不支持他汀类药物降低总前列腺癌风险的假设。然而，需要进一步的研究来调查他汀类药物的使用与晚期前列腺癌风险较低之间的特定关联是否确实是因果关系。(C)2008年Wiley-Liss，Inc.
Statins have been suggested to prevent prostate cancer. Our aim was to examine statin use in relation to both total prostate cancer and the more clinically important advanced prostate cancer, through a detailed metaanalysis of the epidemiologic studies published on the subject in peer-reviewed literature. A comprehensive search for articles published up to November 2007 was performed, reviews of each study were conducted and data were abstracted. Prior to metaanalysis, the studies were evaluated for publication bias and heterogeneity. Pooled relative risk (RR) estimates and 95% confidence intervals (CIs) were calculated using the random-effects model. Subgroup and sensitivity analyses were also performed. Nineteen studies [6 randomized clinical trials (RCTs), 6 cohort and 7 case-control studies] contributed to the analysis. There was no evidence of an association between statin use and total prostate cancer among either RCTs (RR = 1.06, 95% CI: 0.93-1.20) or the observational studies (RR = 0.89, 95% CI: 0.65-1.24). However, high heterogeneity was detected among the observational studies. Moreover, long-term statin use did not significantly affect the risk of total prostate cancer (RR = 0.93, 95% CI: 0.77-1.13). In contrast, synthesis of the available reports that had specifically examined statin use in relation to advanced prostate cancer indicated a protective association (RR = 0.77, 95% CI: 0.64-0.93). Our results do not support the hypothesis that statins reduce the risk of total prostate cancer. However, further research is required to investigate whether the particular association of statin use with lower risk of advanced prostate cancer is indeed causal. (c) 2008 Wiley-Liss, Inc.