Meta-Analysis
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World J Meta-Anal. Nov 26, 2013; 1(3): 130-137
Published online Nov 26, 2013. doi: 10.13105/wjma.v1.i3.130
Statin use and risk of liver cancer: A meta-analysis of 7 studies involving more than 4.7 million patients
Hui Zhang, Chun Gao, Long Fang, Shu-Kun Yao
Hui Zhang, Department of Gastroenterology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
Chun Gao, Long Fang, Shu-Kun Yao, Department of Gastroenterology, China-Japan Friendship Hospital, Ministry of Health, Beijing 100029, China
Author contributions: Zhang H participated in the acquisition of data, statistical analysis and manuscript writing; Gao C and Fang L conceived the study and participated in the study design, acquisition of data, statistical analysis and manuscript writing; Yao SK participated in the critical revision of the manuscript for important intellectual content; and all authors have read and approved the final manuscript.
Supported by Beijing NOVA Programme, No. Z131107000413067; and the Research Fund of the China-Japan Friendship Hospital, Nos. 2013-QN-07 and 2013-QN-06
Correspondence to: Chun Gao, MD, Department of Gastroenterology, China-Japan Friendship Hospital, Ministry of Health, No. 2 Yinghua East Road, Beijing 100029, China. gaochun@bjmu.edu.cn
Telephone: +86-10-84205313 Fax: +86-10-84205313
Received: June 21, 2013
Revised: September 12, 2013
Accepted: November 20, 2013
Published online: November 26, 2013
Abstract

AIM: To pool data currently available to determine the association between statin use and the risk of liver cancer.

METHODS: A computerized literature search was conducted to identify those relevant studies between January 1966 and March 2013. Stata 11.0 (Stata Corp, College Station, Texas) was used for statistical analyses. Pooled relative risk (RR) estimates with 95%CI were calculated for overall analysis and subgroup analyses, using the random- and fixed-effects models. Heterogeneities between studies were evaluated by Cochran’s Q test and I2 statistic. The Begg’s funnel plot and Egger’s regression asymmetry test were used to detect the publication bias.

RESULTS: Seven studies were included in our meta-analysis according to the selection criteria, including four cohort studies and three case-control studies. These studies involved 4725593 people and 9785 liver cancer cases. The overall analysis showed that statin use was statistically associated with a significantly reduced risk of liver cancer (random-effects model, RR = 0.61, 95%CI: 0.49-0.76, P < 0.001; fixed-effects model, RR = 0.64, 95%CI: 0.57-0.71, P < 0.001); however, significant heterogeneity was found between studies (Cochran’s Q statistic = 19.13, P = 0.004; I2 = 68.6%). All subgroup analyses provided supporting evidence for the results of overall analysis. Begg’s (Z = 0.15, P = 0.881) and Egger’s test (t =-0.44, P = 0.681) showed no significant risk of having a publication bias.

CONCLUSION: Statin use was associated with the reduced risk of liver cancer. To clearly clarify this relationship, more high quality studies are required.

Keywords: Statin use, Liver cancer, Reduced risk, Meta-analysis

Core tip: Statin use has been suggested to be associated with the risk of liver cancer by some studies, but no consensus was reached among them. This meta-analysis involved 4725593 people, 9785 liver cancer cases, and found that statin use was associated with the reduced risk of liver cancer (RR = 0.67, 95%CI: 0.55-0.82, P < 0.001).