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Exploring association between statin use and breast cancer risk: an updated meta-analysis

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Abstract

Purpose

The benefits of statin treatment for preventing cardiac disease are well established. However, preclinical studies suggested that statins may influence mammary cancer growth, but the clinical evidence is still inconsistent. We, therefore, performed an updated meta-analysis to provide a precise estimate of the risk of breast cancer in individuals undergoing statin therapy.

Methods

For this meta-analysis, we searched PubMed, the Cochrane Library, Web of Science, Embase, and CINAHL for published studies up to January 31, 2017. Articles were included if they (1) were published in English; (2) had an observational study design with individual-level exposure and outcome data, examined the effect of statin therapy, and reported the incidence of breast cancer; and (3) reported estimates of either the relative risk, odds ratios, or hazard ratios with 95% confidence intervals (CIs). We used random-effect models to pool the estimates.

Results

Of 2754 unique abstracts, 39 were selected for full-text review, and 36 studies reporting on 121,399 patients met all inclusion criteria. The overall pooled risks of breast cancer in patients using statins were 0.94 (95% CI 0.86–1.03) in random-effect models with significant heterogeneity between estimates (I 2 = 83.79%, p = 0.0001). However, we also stratified by region, the duration of statin therapy, methodological design, statin properties, and individual stain use.

Conclusions

Our results suggest that there is no association between statin use and breast cancer risk. However, observational studies cannot clarify whether the observed epidemiologic association is a causal effect or the result of some unmeasured confounding variable. Therefore, more research is needed.

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Fig. 1

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Acknowledgements

This research was sponsored in part by the Ministry of Science and Technology (MOST) under Grants MOST 103-2221-E-038-014, MOST 103-2221-E-038-016, MOST 104-2221-E-038-013, and MOST 104-3011-E-038-001, by the Health and Welfare Surcharge of Tobacco Products under grant MOHW104-TDU-B-212-124-001, and by the Ministry of Education, Taiwan, under Grant TMUTOP103006-6.

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  1. Md. Mohaimenul Islam and Hsuan-Chia Yang have equally contributed.

Authors and Affiliations

  1. Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, 250 Wu-Hsing St., Taipei, 110, Taiwan

    Md. Mohaimenul Islam, Tahmina Nasrin Poly, Shwetambara Kekade, Yu-Chuan Jack Li & Shabbir Syed Abdul

  2. International Center for Health Information Technology (ICHIT), Taipei Medical University, Taipei, Taiwan

    Md. Mohaimenul Islam, Hsuan-Chia Yang, Phung-Anh Nguyen, Chih-Wei Huang, Shwetambara Kekade, Yu-Chuan Jack Li & Shabbir Syed Abdul

  3. Department of Computing and Information Systems, College of Business Studies, PAAET, Hawalli, Kuwait

    Abdulwahed Mohammed Khalfan

  4. Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, Taiwan

    Tonmoy Debnath

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Contributions

MMI: data collection, idea generation, and writing manuscript H-CY: data analysis, P-AN and C-WH: method development, TNP and SK: supporting data collection and drafting manuscript, AMK: method and analysis, TD: data collection Y-CJL, and SSA: supervision.

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Correspondence to Shabbir Syed Abdul.

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Islam, M.M., Yang, HC., Nguyen, PA. et al. Exploring association between statin use and breast cancer risk: an updated meta-analysis. Arch Gynecol Obstet 296, 1043–1053 (2017). https://doi.org/10.1007/s00404-017-4533-3

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