Lack of effect of lowering LDL cholesterol on cancer: Meta-analysis of individual data from 175,000 people in 27 randomised trials of statin therapy

Jonathan R. Emberson; Patricia M. Kearney; Lisa Blackwell; Connie Newman; Christina Reith; Neeraj Bhala; Lisa Holland; Richard Peto; Anthony Keech; Rory Collins; John Simes; Colin Baigent; J. De Lemos; E. Braunwald; M. Blazing; S. Murphy; J. R. Downs; A. Gotto; M. Clearfield; H. Holdaas; D. Gordon; B. Davis; M. Koren; B. Dahlof; N. Poulter; P. Sever; R. H. Knopp; B. Fellström; A. Jardine; R. Schmieder; F. Zannad; U. Goldbourt; E. Kaplinsky; H. M. Colhoun; D. J. Betteridge; P. N. Durrington; G. A. Hitman; J. Fuller; A. Neil; C. Wanner; V. Krane; F. Sacks; L. Moyé; M. Pfeffer; C. M. Hawkins; J. Kjekshus; H. Wedel; J. Wikstrand; L. Tavazzi; A. Maggioni; R. Marchioli; G. Tognoni; M. G. Franzosi; J. Armitage; S. Parish; P. Sleight; T. R. Pedersen; P. M. Ridker; S. MacMahon; I. Marschner; A. Tonkin; J. Shaw; P. W. Serruys; H. Nakamura; G. Knatterud; C. Furberg; R. Byington; P. Macfarlane; S. Cobbe; I. Ford; M. Murphy; G. J. Blauw; C. Packard; J. Shepherd; L. Wilhelmsen; C. Cannon; L. Bowman; J. La Rosa; M. Flather; J. Kastelein; C. Shear; J. Tobert; J. Varigos; H. White; S. Yusuf; A. Baxter; E. H. Barnes; G. Buck; W. G. Herrington; A. Kirby; D. A. Lewis; M. Mellies; M. McGovern; J. Barclay; R. Belder; Y. Mitchell; T. Musliner; J. C. Ansquer; M. Llewellyn; M. Bortolini; B. Bryzinski; G. Olsson; J. Pears; D. DeMicco

doi:10.1371/journal.pone.0029849

Lack of effect of lowering LDL cholesterol on cancer: Meta-analysis of individual data from 175,000 people in 27 randomised trials of statin therapy

Jonathan R. Emberson, Patricia M. Kearney, Lisa Blackwell, Connie Newman, Christina Reith, Neeraj Bhala, Lisa Holland, Richard Peto, Anthony Keech, Rory Collins, John Simes, Colin Baigent, J. De Lemos, E. Braunwald, M. Blazing, S. Murphy, J. R. Downs, A. Gotto, M. Clearfield, H. HoldaasD. Gordon, B. Davis, M. Koren, B. Dahlof, N. Poulter, P. Sever, R. H. Knopp, B. Fellström, A. Jardine, R. Schmieder, F. Zannad, U. Goldbourt, E. Kaplinsky, H. M. Colhoun, D. J. Betteridge, P. N. Durrington, G. A. Hitman, J. Fuller, A. Neil, C. Wanner, V. Krane, F. Sacks, L. Moyé, M. Pfeffer, C. M. Hawkins, J. Kjekshus, H. Wedel, J. Wikstrand, L. Tavazzi, A. Maggioni, R. Marchioli, G. Tognoni, M. G. Franzosi, J. Armitage, S. Parish, P. Sleight, T. R. Pedersen, P. M. Ridker, S. MacMahon, I. Marschner, A. Tonkin, J. Shaw, P. W. Serruys, H. Nakamura, G. Knatterud, C. Furberg, R. Byington, P. Macfarlane, S. Cobbe, I. Ford, M. Murphy, G. J. Blauw, C. Packard, J. Shepherd, L. Wilhelmsen, C. Cannon, L. Bowman, J. La Rosa, M. Flather, J. Kastelein, C. Shear, J. Tobert, J. Varigos, H. White, S. Yusuf, A. Baxter, E. H. Barnes, G. Buck, W. G. Herrington, A. Kirby, D. A. Lewis, M. Mellies, M. McGovern, J. Barclay, R. Belder, Y. Mitchell, T. Musliner, J. C. Ansquer, M. Llewellyn, M. Bortolini, B. Bryzinski, G. Olsson, J. Pears, D. DeMicco

Research output: Contribution to journal › Article › peer-review

299 Scopus citations

Abstract

Background: Statin therapy reduces the risk of occlusive vascular events, but uncertainty remains about potential effects on cancer. We sought to provide a detailed assessment of any effects on cancer of lowering LDL cholesterol (LDL-C) with a statin using individual patient records from 175,000 patients in 27 large-scale statin trials. Methods and Findings: Individual records of 134,537 participants in 22 randomised trials of statin versus control (median duration 4.8 years) and 39,612 participants in 5 trials of more intensive versus less intensive statin therapy (median duration 5.1 years) were obtained. Reducing LDL-C with a statin for about 5 years had no effect on newly diagnosed cancer or on death from such cancers in either the trials of statin versus control (cancer incidence: 3755 [1.4% per year [py]] versus 3738 [1.4% py], RR 1.00 [95% CI 0.96-1.05]; cancer mortality: 1365 [0.5% py] versus 1358 [0.5% py], RR 1.00 [95% CI 0.93-1.08]) or in the trials of more versus less statin (cancer incidence: 1466 [1.6% py] vs 1472 [1.6% py], RR 1.00 [95% CI 0.93-1.07]; cancer mortality: 447 [0.5% py] versus 481 [0.5% py], RR 0.93 [95% CI 0.82-1.06]). Moreover, there was no evidence of any effect of reducing LDL-C with statin therapy on cancer incidence or mortality at any of 23 individual categories of sites, with increasing years of treatment, for any individual statin, or in any given subgroup. In particular, among individuals with low baseline LDL-C (<2 mmol/L), there was no evidence that further LDL-C reduction (from about 1.7 to 1.3 mmol/L) increased cancer risk (381 [1.6% py] versus 408 [1.7% py]; RR 0.92 [99% CI 0.76-1.10]). Conclusions: In 27 randomised trials, a median of five years of statin therapy had no effect on the incidence of, or mortality from, any type of cancer (or the aggregate of all cancer).

Original language	English
Article number	e29849
Journal	PLoS ONE
Volume	7
Issue number	1
DOIs	https://doi.org/10.1371/journal.pone.0029849
State	Published - 19 Jan 2012

Funding

Funders	Funder number
Bristol-Myers Squibb
Pfizer
AstraZeneca
Merck
Novartis
Medical Research Council	MC_U137686849

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1371/journal.pone.0029849

Cite this

Emberson, J. R., Kearney, P. M., Blackwell, L., Newman, C., Reith, C., Bhala, N., Holland, L., Peto, R., Keech, A., Collins, R., Simes, J., Baigent, C., De Lemos, J., Braunwald, E., Blazing, M., Murphy, S., Downs, J. R., Gotto, A., Clearfield, M., ... DeMicco, D. (2012). Lack of effect of lowering LDL cholesterol on cancer: Meta-analysis of individual data from 175,000 people in 27 randomised trials of statin therapy. PLoS ONE, 7(1), Article e29849. https://doi.org/10.1371/journal.pone.0029849

@article{01989bde9abd492faf724f55904965e7,

title = "Lack of effect of lowering LDL cholesterol on cancer: Meta-analysis of individual data from 175,000 people in 27 randomised trials of statin therapy",

abstract = "Background: Statin therapy reduces the risk of occlusive vascular events, but uncertainty remains about potential effects on cancer. We sought to provide a detailed assessment of any effects on cancer of lowering LDL cholesterol (LDL-C) with a statin using individual patient records from 175,000 patients in 27 large-scale statin trials. Methods and Findings: Individual records of 134,537 participants in 22 randomised trials of statin versus control (median duration 4.8 years) and 39,612 participants in 5 trials of more intensive versus less intensive statin therapy (median duration 5.1 years) were obtained. Reducing LDL-C with a statin for about 5 years had no effect on newly diagnosed cancer or on death from such cancers in either the trials of statin versus control (cancer incidence: 3755 [1.4% per year [py]] versus 3738 [1.4% py], RR 1.00 [95% CI 0.96-1.05]; cancer mortality: 1365 [0.5% py] versus 1358 [0.5% py], RR 1.00 [95% CI 0.93-1.08]) or in the trials of more versus less statin (cancer incidence: 1466 [1.6% py] vs 1472 [1.6% py], RR 1.00 [95% CI 0.93-1.07]; cancer mortality: 447 [0.5% py] versus 481 [0.5% py], RR 0.93 [95% CI 0.82-1.06]). Moreover, there was no evidence of any effect of reducing LDL-C with statin therapy on cancer incidence or mortality at any of 23 individual categories of sites, with increasing years of treatment, for any individual statin, or in any given subgroup. In particular, among individuals with low baseline LDL-C (<2 mmol/L), there was no evidence that further LDL-C reduction (from about 1.7 to 1.3 mmol/L) increased cancer risk (381 [1.6% py] versus 408 [1.7% py]; RR 0.92 [99% CI 0.76-1.10]). Conclusions: In 27 randomised trials, a median of five years of statin therapy had no effect on the incidence of, or mortality from, any type of cancer (or the aggregate of all cancer).",

author = "Emberson, {Jonathan R.} and Kearney, {Patricia M.} and Lisa Blackwell and Connie Newman and Christina Reith and Neeraj Bhala and Lisa Holland and Richard Peto and Anthony Keech and Rory Collins and John Simes and Colin Baigent and {De Lemos}, J. and E. Braunwald and M. Blazing and S. Murphy and Downs, {J. R.} and A. Gotto and M. Clearfield and H. Holdaas and D. Gordon and B. Davis and M. Koren and B. Dahlof and N. Poulter and P. Sever and Knopp, {R. H.} and B. Fellstr{\"o}m and A. Jardine and R. Schmieder and F. Zannad and U. Goldbourt and E. Kaplinsky and Colhoun, {H. M.} and Betteridge, {D. J.} and Durrington, {P. N.} and Hitman, {G. A.} and J. Fuller and A. Neil and C. Wanner and V. Krane and F. Sacks and L. Moy{\'e} and M. Pfeffer and Hawkins, {C. M.} and J. Kjekshus and H. Wedel and J. Wikstrand and L. Tavazzi and A. Maggioni and R. Marchioli and G. Tognoni and Franzosi, {M. G.} and J. Armitage and S. Parish and P. Sleight and Pedersen, {T. R.} and Ridker, {P. M.} and S. MacMahon and I. Marschner and A. Tonkin and J. Shaw and Serruys, {P. W.} and H. Nakamura and G. Knatterud and C. Furberg and R. Byington and P. Macfarlane and S. Cobbe and I. Ford and M. Murphy and Blauw, {G. J.} and C. Packard and J. Shepherd and L. Wilhelmsen and C. Cannon and L. Bowman and {La Rosa}, J. and M. Flather and J. Kastelein and C. Shear and J. Tobert and J. Varigos and H. White and S. Yusuf and A. Baxter and Barnes, {E. H.} and G. Buck and Herrington, {W. G.} and A. Kirby and Lewis, {D. A.} and M. Mellies and M. McGovern and J. Barclay and R. Belder and Y. Mitchell and T. Musliner and Ansquer, {J. C.} and M. Llewellyn and M. Bortolini and B. Bryzinski and G. Olsson and J. Pears and D. DeMicco",

note = "Publisher Copyright: {\textcopyright} 2012 CTT Collaboration.",

year = "2012",

month = jan,

day = "19",

doi = "10.1371/journal.pone.0029849",

language = "אנגלית",

volume = "7",

journal = "PLoS ONE",

issn = "1932-6203",

publisher = "Public Library of Science",

number = "1",

}

Emberson, JR, Kearney, PM, Blackwell, L, Newman, C, Reith, C, Bhala, N, Holland, L, Peto, R, Keech, A, Collins, R, Simes, J, Baigent, C, De Lemos, J, Braunwald, E, Blazing, M, Murphy, S, Downs, JR, Gotto, A, Clearfield, M, Holdaas, H, Gordon, D, Davis, B, Koren, M, Dahlof, B, Poulter, N, Sever, P, Knopp, RH, Fellström, B, Jardine, A, Schmieder, R, Zannad, F, Goldbourt, U , Kaplinsky, E, Colhoun, HM, Betteridge, DJ, Durrington, PN, Hitman, GA, Fuller, J, Neil, A, Wanner, C, Krane, V, Sacks, F, Moyé, L, Pfeffer, M, Hawkins, CM, Kjekshus, J, Wedel, H, Wikstrand, J, Tavazzi, L, Maggioni, A, Marchioli, R, Tognoni, G, Franzosi, MG, Armitage, J, Parish, S, Sleight, P, Pedersen, TR, Ridker, PM, MacMahon, S, Marschner, I, Tonkin, A, Shaw, J, Serruys, PW, Nakamura, H, Knatterud, G, Furberg, C, Byington, R, Macfarlane, P, Cobbe, S, Ford, I, Murphy, M, Blauw, GJ, Packard, C, Shepherd, J, Wilhelmsen, L, Cannon, C, Bowman, L, La Rosa, J, Flather, M, Kastelein, J, Shear, C, Tobert, J, Varigos, J, White, H, Yusuf, S, Baxter, A, Barnes, EH, Buck, G, Herrington, WG, Kirby, A, Lewis, DA, Mellies, M, McGovern, M, Barclay, J, Belder, R, Mitchell, Y, Musliner, T, Ansquer, JC, Llewellyn, M, Bortolini, M, Bryzinski, B, Olsson, G, Pears, J & DeMicco, D 2012, 'Lack of effect of lowering LDL cholesterol on cancer: Meta-analysis of individual data from 175,000 people in 27 randomised trials of statin therapy', PLoS ONE, vol. 7, no. 1, e29849. https://doi.org/10.1371/journal.pone.0029849

TY - JOUR

T1 - Lack of effect of lowering LDL cholesterol on cancer

T2 - Meta-analysis of individual data from 175,000 people in 27 randomised trials of statin therapy

AU - Emberson, Jonathan R.

AU - Kearney, Patricia M.

AU - Blackwell, Lisa

AU - Newman, Connie

AU - Reith, Christina

AU - Bhala, Neeraj

AU - Holland, Lisa

AU - Peto, Richard

AU - Keech, Anthony

AU - Collins, Rory

AU - Simes, John

AU - Baigent, Colin

AU - De Lemos, J.

AU - Braunwald, E.

AU - Blazing, M.

AU - Murphy, S.

AU - Downs, J. R.

AU - Gotto, A.

AU - Clearfield, M.

AU - Holdaas, H.

AU - Gordon, D.

AU - Davis, B.

AU - Koren, M.

AU - Dahlof, B.

AU - Poulter, N.

AU - Sever, P.

AU - Knopp, R. H.

AU - Fellström, B.

AU - Jardine, A.

AU - Schmieder, R.

AU - Zannad, F.

AU - Goldbourt, U.

AU - Kaplinsky, E.

AU - Colhoun, H. M.

AU - Betteridge, D. J.

AU - Durrington, P. N.

AU - Hitman, G. A.

AU - Fuller, J.

AU - Neil, A.

AU - Wanner, C.

AU - Krane, V.

AU - Sacks, F.

AU - Moyé, L.

AU - Pfeffer, M.

AU - Hawkins, C. M.

AU - Kjekshus, J.

AU - Wedel, H.

AU - Wikstrand, J.

AU - Tavazzi, L.

AU - Maggioni, A.

AU - Marchioli, R.

AU - Tognoni, G.

AU - Franzosi, M. G.

AU - Armitage, J.

AU - Parish, S.

AU - Sleight, P.

AU - Pedersen, T. R.

AU - Ridker, P. M.

AU - MacMahon, S.

AU - Marschner, I.

AU - Tonkin, A.

AU - Shaw, J.

AU - Serruys, P. W.

AU - Nakamura, H.

AU - Knatterud, G.

AU - Furberg, C.

AU - Byington, R.

AU - Macfarlane, P.

AU - Cobbe, S.

AU - Ford, I.

AU - Murphy, M.

AU - Blauw, G. J.

AU - Packard, C.

AU - Shepherd, J.

AU - Wilhelmsen, L.

AU - Cannon, C.

AU - Bowman, L.

AU - La Rosa, J.

AU - Flather, M.

AU - Kastelein, J.

AU - Shear, C.

AU - Tobert, J.

AU - Varigos, J.

AU - White, H.

AU - Yusuf, S.

AU - Baxter, A.

AU - Barnes, E. H.

AU - Buck, G.

AU - Herrington, W. G.

AU - Kirby, A.

AU - Lewis, D. A.

AU - Mellies, M.

AU - McGovern, M.

AU - Barclay, J.

AU - Belder, R.

AU - Mitchell, Y.

AU - Musliner, T.

AU - Ansquer, J. C.

AU - Llewellyn, M.

AU - Bortolini, M.

AU - Bryzinski, B.

AU - Olsson, G.

AU - Pears, J.

AU - DeMicco, D.

PY - 2012/1/19

Y1 - 2012/1/19

N2 - Background: Statin therapy reduces the risk of occlusive vascular events, but uncertainty remains about potential effects on cancer. We sought to provide a detailed assessment of any effects on cancer of lowering LDL cholesterol (LDL-C) with a statin using individual patient records from 175,000 patients in 27 large-scale statin trials. Methods and Findings: Individual records of 134,537 participants in 22 randomised trials of statin versus control (median duration 4.8 years) and 39,612 participants in 5 trials of more intensive versus less intensive statin therapy (median duration 5.1 years) were obtained. Reducing LDL-C with a statin for about 5 years had no effect on newly diagnosed cancer or on death from such cancers in either the trials of statin versus control (cancer incidence: 3755 [1.4% per year [py]] versus 3738 [1.4% py], RR 1.00 [95% CI 0.96-1.05]; cancer mortality: 1365 [0.5% py] versus 1358 [0.5% py], RR 1.00 [95% CI 0.93-1.08]) or in the trials of more versus less statin (cancer incidence: 1466 [1.6% py] vs 1472 [1.6% py], RR 1.00 [95% CI 0.93-1.07]; cancer mortality: 447 [0.5% py] versus 481 [0.5% py], RR 0.93 [95% CI 0.82-1.06]). Moreover, there was no evidence of any effect of reducing LDL-C with statin therapy on cancer incidence or mortality at any of 23 individual categories of sites, with increasing years of treatment, for any individual statin, or in any given subgroup. In particular, among individuals with low baseline LDL-C (<2 mmol/L), there was no evidence that further LDL-C reduction (from about 1.7 to 1.3 mmol/L) increased cancer risk (381 [1.6% py] versus 408 [1.7% py]; RR 0.92 [99% CI 0.76-1.10]). Conclusions: In 27 randomised trials, a median of five years of statin therapy had no effect on the incidence of, or mortality from, any type of cancer (or the aggregate of all cancer).

AB - Background: Statin therapy reduces the risk of occlusive vascular events, but uncertainty remains about potential effects on cancer. We sought to provide a detailed assessment of any effects on cancer of lowering LDL cholesterol (LDL-C) with a statin using individual patient records from 175,000 patients in 27 large-scale statin trials. Methods and Findings: Individual records of 134,537 participants in 22 randomised trials of statin versus control (median duration 4.8 years) and 39,612 participants in 5 trials of more intensive versus less intensive statin therapy (median duration 5.1 years) were obtained. Reducing LDL-C with a statin for about 5 years had no effect on newly diagnosed cancer or on death from such cancers in either the trials of statin versus control (cancer incidence: 3755 [1.4% per year [py]] versus 3738 [1.4% py], RR 1.00 [95% CI 0.96-1.05]; cancer mortality: 1365 [0.5% py] versus 1358 [0.5% py], RR 1.00 [95% CI 0.93-1.08]) or in the trials of more versus less statin (cancer incidence: 1466 [1.6% py] vs 1472 [1.6% py], RR 1.00 [95% CI 0.93-1.07]; cancer mortality: 447 [0.5% py] versus 481 [0.5% py], RR 0.93 [95% CI 0.82-1.06]). Moreover, there was no evidence of any effect of reducing LDL-C with statin therapy on cancer incidence or mortality at any of 23 individual categories of sites, with increasing years of treatment, for any individual statin, or in any given subgroup. In particular, among individuals with low baseline LDL-C (<2 mmol/L), there was no evidence that further LDL-C reduction (from about 1.7 to 1.3 mmol/L) increased cancer risk (381 [1.6% py] versus 408 [1.7% py]; RR 0.92 [99% CI 0.76-1.10]). Conclusions: In 27 randomised trials, a median of five years of statin therapy had no effect on the incidence of, or mortality from, any type of cancer (or the aggregate of all cancer).

UR - http://www.scopus.com/inward/record.url?scp=84930670749&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0029849

DO - 10.1371/journal.pone.0029849

M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???

AN - SCOPUS:84930670749

SN - 1932-6203

VL - 7

JO - PLoS ONE

JF - PLoS ONE

IS - 1

M1 - e29849

ER -

Lack of effect of lowering LDL cholesterol on cancer: Meta-analysis of individual data from 175,000 people in 27 randomised trials of statin therapy

Abstract

Funding

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this