Statin use and cancer risk: a comprehensive review

Abstract

Importance of the Field-HMG-CoA inhibitors (statins), a class of drugs that reduce cholesterol, are used to manage and prevent coronary heart disease. They are among the most commonly prescribed drugs worldwide. Contrary to early concerns over the carcinogenicity of statins, a growing body of evidence suggests statins may in fact have a chemopreventive potential against cancer.Areas Covered in This Review-In this paper, we review evidence on the association between statin use and cancer risk. Specifically, we report on clinical trials and observational studies that measured all cancer or site-specific cancers of the breast, colorectal, lung, prostate, and reproductive organs associated with statin use.What the reader will gain-An understanding of the evidence, including strengths and limitations, to support an association between statins and cancer. Information on the current state of the field and future directions are also discussed.Take Home Message-Few strong or consistent associations between statins and cancer incidence overall or for any of the sites reviewed were detected. Data is lacking for any effects of statins on cancer prognosis and secondary prevention; with the exception of consistent evidence that statins are associated with reduced risk of advanced/aggressive prostate cancer. Statins appear safe in relation to cancer risk but any chemopreventive effect in humans remains to be established and should not be recommended outside the context of clinical trials. It is encouraging that numerous trials are on-going. The prospect of reducing the incidence and burden of some of the most prevalent cancers with a safe, affordable, and tolerable medication that already reduces the risk of the leading cause of death, cardiovascular disease, warrants further exploration in clinical trials and observational studies of prognosis and survival.

Antitumor effects of atorvastatin in the chemoprevention of rat mammary carcinogenesis

“…With regard to clinical research, only few consistent associations between statins and cancer incidence were observed (Boudreau et al 2010). There are reports from clinical trials and observational studies that evaluated all cancers (Jacobs et al 2011) or site-specific cancer of breast (Woditska et al 2010), colorectum (Yano et al 2008), lung (Khurana et al 2007), prostate (Bonovas et al 2008), and reproductive organs (Yu et al 2009) associated with the statins use.…”

Targeting tumor cell metabolism with statins

“…75,80,81,88 Most importantly, several prospective clinical trials addressing whether statins decrease cancer incidence are now underway. 89 The immunomodulatory nature of statins Statins are also known to have a variety of immunomodulatory effects. There has been some degree of contradiction, as it has been suggested that this effect could both inhibit and accelerate transformation.…”

The role of statins as therapeutic agents in cancer

“…Pravastatin is extremely hydrophilic compared to the other statins. Its intermediate physiochemical properties and differences in hydrophilicity may have clinical significance with respect to factors such as cancer risk (Boudreau et al 2010). Hydrophilic statin pravastatin is more hepatoselective than lipophilic statins cerivastatin, simvastatin, lovastatin, mevastatin, atorvastatin, rosuvastatin and fluvastatin, whereupon is pravastatin actively transported into the liver by members of the organic anion transporting polypeptide family (also known as OATPs).…”