Statin use and breast cancer survival and risk: a systematic review and meta-analysis
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Qi-Jun Wu1,*, Chao Tu2,*, Yuan-Yuan Li3, Jingjing Zhu4,5, Ke-Qing Qian2, Wen-Jing Li2, Lang Wu5,6
1Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China
2Oncology Institute, the Affiliated Hospital of Nanjing Medical University, Changzhou No.2 People’s Hospital, Changzhou, Jiangsu 213003, China
3Department of Hematology, the Affiliated Hospital of Xuzhou Medical College, Xuzhou, Jiangsu 221000, China
4Program of Quantitative Methods in Education, University of Minnesota, Minneapolis, Minnesota 55455, USA
5Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee 37203, USA
6Center for Clinical and Translational Science, Mayo Clinic, Rochester, Minnesota 55905, USA
*These authors have contributed equally to this work
Qi-Jun Wu, e-mail: [email protected]
Lang Wu, e-mail: [email protected]
Keywords: statin, breast cancer, risk, mortality, meta-analysis
Received: August 04, 2015 Accepted: September 06, 2015 Published: October 12, 2015
The purpose of this study is to determine the associations between statin use and breast cancer survival and risk by performing a systematic review and meta-analysis. We searched PubMed, Embase and Web of Science up to August 2015 for identifying relevant prospective or case-control studies, or randomized clinical trials. Five prospective studies involving 60,911 patients reported the association between statin use and breast cancer mortality. Eleven prospective studies, 12 case-control studies and 9 randomized clinical trials involving 83,919 patients reported the association between statin use and breast cancer risk. After pooling estimates from all available studies, there was a significantly negative association between pre-diagnosis statin use and breast cancer mortality (for overall survival (OS): hazard ratio (HR) = 0.68, 95% confidence interval (CI) 0.54–0.84; for disease specific survival (DSS): HR = 0.72, 95% CI 0.53–0.99). There was also a significant inverse association between post-diagnosis statin use and breast cancer DSS (HR = 0.65, 95% CI 0.43–0.98), although the association with breast cancer OS did not reach statistical significance (HR = 0.71, 95% CI 0.48–1.07). Additionally, there was a non-linear relationship for the duration of post-diagnosis statin use with breast cancer specific mortality. On the other hand, with regards to the relationship between statin use and breast cancer risk, no significant association was detected. Our analyses suggest that although statin use may not influence breast cancer risk, the use of statin may be associated with decrease mortality of breast cancer patients. Further large-scale studies are warranted to validate our findings.
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