Statin use and non-melanoma skin cancer risk: a meta-analysis of randomized controlled trials and observational studies
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Keming Yang1, Andrew Marley1, Huilin Tang1, Yiqing Song1, Jean Y. Tang2 and Jiali Han1
1Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN 46202-2872, USA
2Department of Dermatology, Stanford University School of Medicine, Stanford, CA 94063, USA
Jiali Han, email: firstname.lastname@example.org
Keywords: statins, non-melanoma skin cancer, meta-analysis
Received: June 26, 2017 Accepted: July 26, 2017 Published: August 08, 2017
Background: Existing evidence of the association between statin use and non-melanoma skin cancer (NMSC) risk has been inconsistent.
Objective: To maximize statistical power to synthesize prospective evidence on this relationship.
Materials and Methods: PubMed, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, and ClinicalTrial.gov were systematically searched up to December 11, 2016. A random-effects meta-analysis was conducted to calculate summary estimates.
Results: Our meta-analysis of 14 randomized controlled trials (RCTs) including 63,157 subjects showed no significant association between statin use and NMSC risk (RR = 1.09, 95%CI = 0.85–1.39). However, meta-analysis of four observational studies including 1,528,215 participants showed significantly increased risk of NMSC among statin users compared to non-users (RR = 1.11, 95%CI = 1.02–1.22). Furthermore, ever using lipophilic statins (RR = 1.14, 95%CI = 1.04–1.24) or lower-potency statins (RR = 1.14, 95%CI = 1.03–1.26), as well as usage of any statin longer than one year (RR = 1.14, 95%CI = 1.09–1.18) were significantly associated with increased NMSC risk based on observational studies.
Conclusions: Evidence from observational studies supported an association between statin use and increased NMSC risk. This finding should be interpreted with caution due to modest number of included studies, possible between-study heterogeneity and inherent limitations of observational studies.
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