TABLE 1.
Hepatocellular carcinoma risk among statin users
| No, of studies | Sample size | HR | 95% confidence interval | p value | I2 (%) | p value for Cochran Q test of heterogeneity | Subgroup difference | |
|---|---|---|---|---|---|---|---|---|
| Statins | ||||||||
| Overall | 10 | 1,774,476 | 0.52 | 0.37–0.72 | <0.01 * | 97.80 | <0.01 | |
| Cirrhosis | 3 | 21,534 | 0.95 | 0.91–0.99 | 0.04 * | 90.20 | <0.01 | |
| Hepatitis B | 5 | 152,716 | 0.53 | 0.32–0.88 | 0.01 * | 96.70 | <0.01 | |
| Hepatitis C | 3 | 16,058 | 0.79 | 0.64–0.99 | 0.04 * | 81.70 | <0.01 | |
| NAFLD | 2 | 242,751 | 0.68 | 0.59–0.77 | <0.01 * | 90.80 | <0.01 | |
| Accounted for competing risk of death without HCC | 5 | 980,486 | 0.51 | 0.32–0.81 | <0.01 * | 97.50 | <0.01 | |
| Sex | ||||||||
| Male | 2 | 115,411 | 0.45 | 0.24–0.85 | 0.01 * | 85.90 | <0.01 | 0.83 |
| Female | 2 | 115,411 | 0.50 | 0.22–1.17 | 0.11 | 75.00 | 0.01 | |
| HCC diagnosis method | ||||||||
| Verified by imaging/histology | 2 | 66,445 | 0.60 | 0.33–1.09 | 0.09 | 95.10 | <0.01 | 0.59 |
| ICD codes | 8 | 1,708,031 | 0.49 | 0.31–078 | <0.01 * | 98.60 | <0.01 | |
| Statin type | ||||||||
| Lipophilic | 3 | 1,083,952 | 0.46 | 0.37–0.57 | <0.01 | 64.00 | 0.06 | 0.93 |
| Hydrophilic | 3 | 1,083,952 | 0.48 | 0.18–1.27 | 0.14 | 99.10 | <0.01 | |
| Accounted for concurrent use of aspirin, NSAIDs and metformin | ||||||||
| Yes | 9 | 1,534,926 | 0.52 | 0.37–0.75 | <0.01 * | 98.10 | <0.01 | |
| Mean follow-up duration | ||||||||
| <60 months | 4 | 814,691 | 0.49 | 0.39–0.62 | <0.01 * | 49.50 | 0.12 | 0.10 |
| ≥60 months | 4 | 965,093 | 0.67 | 0.49–0.92 | 0.01 * | 96.20 | <0.01 | |
Abbreviations: HCC, hepatocellular carcinoma; LT, liver transplantation; NAFLD, non-alcoholic fatty liver disease; ICD, International Classification of Diseases; HR, hazard ratio; I2, level of heterogeneity.
*
Bolded p ≤ 0.05 denotes statistical significance.