Table 1.
Summary of each individual meta-analysis on associations of the use of statin and all-cause mortality in various cancers.
| Type/Author, Year | Study Design | No of Study | No of Total Participants | Random Effects (Reported) (ES, 95%CI) |
Random Effects (Re-Analyzed) (ES, 95%CI) |
Fixed Effects (Re-Analyzed) (ES, 95%CI) |
Largest Effect § | Egger | I2 (P) † |
P (Random) |
P (Fixed) |
95% PI (Random) |
Small Study Effect | Same Direction | Evidence |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Bladder cancer | |||||||||||||||
| Luo 2015 | Obs | 1 | 1117 | 1.14 (0.89–1.44) |
1.14 (0.89–1.44) |
1.14 (0.89–1.44) |
1.14 (0.89–1.44) |
- | - | 0.286 | 0.286 | NA | - | No | Non-significant |
| Breast cancer | |||||||||||||||
| Mei 2017 | Cohort | 7 | 24,255 | 0.65 (0.43–0.99) |
0.65 (0.43–0.98) |
0.72 (0.67–0.77) |
0.78 (0.72–0.84) |
0.541 | 92.7 (<0.001) | 0.042 | <0.001 | 0.15–2.76 | No | Yes | Weak |
| Liu 2017 | Cohort | 8 | 68,373 | 0.72 (0.58–0.89) |
0.72 (0.58–0.89) |
0.74 (0.69–0.78) |
0.46 (0.38–0.55) |
0.702 | 87.4 (<0.001) | 0.002 | <0.001 | 0.36–1.44 | No | Yes | Weak |
| Manthravadi 2016 | Cohort | 8 | 40,756 | 0.66 (0.44–0.99) |
0.66 (0.44–0.99) |
0.64 (0.57–0.70) |
0.39 (0.33–0.46) |
0.864 | 89.0 (<0.001) | 0.043 | <0.001 | 0.18–2.40 | No | Yes | Weak |
| Zhong 2015 (post-diagnostic) | Obs | 6 | 51,265 | 0.75 (0.55–1.02) |
0.75 (0.55–1.03) |
0.72 (0.64–0.80) |
0.47 (0.38–0.59) |
0.816 | 77.8 (<0.001) | 0.079 | <0.001 | 0.27–2.09 | No | No | Non-significant |
| Zhong 2015 (pre-diagnostic) | Obs | 3 | 49,116 | 0.73 (0.62–0.86) |
0.73 (0.63–0.86) |
0.76 (0.69–0.83) |
0.60 (0.45–0.81) |
0.501 | 33.3 (0.269) | <0.001 | <0.001 | 0.18–2.95 | No | Yes | Suggestive |
| Colorectal cancer | |||||||||||||||
| Mei 2017 | Cohort | 9 | 44,476 | 0.76 (0.68–0.86) |
0.76 (0.68–0.86) |
0.75 (0.72–0.80) |
0.72 (0.67–0.78) |
0.793 | 67.3 (0.002) | <0.001 | <0.001 | 0.54–1.07 | No | Yes | Suggestive * |
| Gray 2016 (post-diagnostic) | Obs | 11 | 21,030 | 0.84 (0.73–0.98) |
0.85 (0.73–0.98) |
0.84 (0.79–0.90) |
0.90 (0.80–1.01) |
0.760 | 69.0 (<0.001) | 0.029 | <0.001 | 0.53–1.34 | No | No | Weak |
| Gray 2016 (pre-diagnostic) | Obs | 6 | 44,026 | 0.85 (0.76–0.96) |
0.85 (0.76–0.96) |
0.84 (0.80–0.88) |
0.85 (0.79–0.92) |
0.720 | 76.0 (<0.001) | 0.011 | <0.001 | 0.59–1.24 | No | Yes | Suggestive * |
| Ling 2015 (post-diagnostic) | Cohort | 5 | 10,038 | 0.93 (0.68–1.27) |
0.93 (0.68–1.27) |
0.81 (0.73–0.90) |
0.75 (0.66–0.84) |
0.443 | 69.4 (0.011) | 0.639 | <0.001 | 0.33–2.59 | No | No | Non-significant |
| Ling 2015 (pre-diagnostic) | Cohort | 4 | 12,396 | 0.73 (0.61–0.88) |
0.73 (0.62–0.86) |
0.74 (0.66–0.84) |
0.81 (0.68–0.96) |
0.251 | 19.9 (0.291) | <0.001 | <0.001 | 0.45–1.19 | No | Yes | Suggestive |
| Cai 2015 (post & pre-diagnostic) | Obs | 4 | 11,786 | 0.76 (0.61–0.95) |
0.79 (0.65–0.95) |
0.79 (0.65–0.95) |
0.71 (0.54–0.94) |
0.587 | 0.0 (0.447) | 0.013 | 0.013 | 0.52–1.18 | No | Yes | Suggestive |
| Cai 2015 (post-diagnostic) | Obs | 4 | 15,862 | 0.76 (0.68–0.85) |
0.76 (0.68–0.85) |
0.76 (0.68–0.85) |
0.75 (0.66–0.84) |
0.723 | 0.0 (0.393) | <0.001 | <0.001 | 0.60–0.96 | No | Yes | Convincing |
| Cai 2015 (pre-diagnostic) | Obs | 2 | 10,553 | 0.70 (0.54–0.91) |
0.70 (0.54–0.91) |
0.70 (0.54–0.91) |
0.71 (0.54–0.94) |
- | 0.0 (0.795) | 0.007 | 0.007 | NA | - | Yes | - |
| Zhong 2015 (post-diagnostic) | Obs | 6 | 12,441 | 0.96 (0.76–1.22) |
0.97 (0.75–1.24) |
0.86 (0.77–0.95) |
0.75 (0.66–0.85) |
0.295 | 65.9 (0.004) | 0.792 | 0.003 | 0.45–2.09 | No | No | Weak |
| Zhong 2015 (pre-diagnostic) | Obs | 3 | 18,733 | 0.77 (0.66–0.89) |
0.78 (0.69–0.88) |
0.79 (0.72–0.87) |
0.82 (0.74–0.91) |
0.353 | 31.4 (0.300) | <0.001 | <0.001 | 0.27–2.25 | No | Yes | Suggestive |
| Endocrine-Related Gynecological Cancer | |||||||||||||||
| Xie 2017 | Obs | 9 | 5449 | - | 0.70 (0.58–0.83) |
0.71 (0.63–0.80) |
0.66 (0.55–0.80) |
0.250 | 33.3 (0.151) | <0.001 | <0.001 | 0.47–1.04 | No | Yes | Suggestive |
| Endometrial Cancer | |||||||||||||||
| Xie 2017 | Obs | 4 | 3460 | - | 0.80 (0.62–1.03) |
0.84 (0.69–1.01) |
0.92 (0.70–1.20) |
0.046 | 0.0 (0.680) | 0.083 | 0.058 | 0.34–1.89 | Yes | Yes | Non-significant |
| Zhong 2015 (post-diagnostic) | Obs | 3 | 3261 | 0.89 (0.72–1.09) |
0.86 (0.64–1.15) |
0.89 (0.72–1.09) |
0.92 (0.70–1.20) |
0.156 | 0.0 (0.203) | 0.309 | 0.255 | 0.05–13.49 | No | Yes | Non-significant |
| Kidney Cancer | |||||||||||||||
| Nayan 2017 | Overall | 7 | 11,491 | 0.74 (0.63–0.88) |
0.74 (0.63–0.88) |
0.78 (0.71–0.87) |
0.80 (0.66–0.97) |
0.057 | 51.8 (0.052) | 0.001 | <0.001 | 0.47–1.17 | Yes | Yes | Weak |
| Luo 2015 | Obs | 3 | 5881 | 0.81 (0.68–0.96) |
0.81 (0.69–0.96) |
0.82 (0.72–0.94) |
0.84 (0.69–1.00) |
0.378 | 26.0 (0.260) | 0.015 | 0.005 | 0.19–3.47 | No | No | Suggestive |
| Lymphoma | |||||||||||||||
| Zhong 2015 (post-diagnostic) | Obs | 3 | 782 | 1.15 (0.85–1.55) |
1.15 (0.85–1.55) |
1.15 (0.85–1.55) |
1.23 (0.88–1.71) |
0.195 | 0.0 (0.602) | 0.362 | 0.362 | 0.16–8.24 | No | Yes | Non-significant |
| Ovarian Cancer | |||||||||||||||
| Li 2018 | Obs | 7 | 16,389 | 0.74 (0.63–0.87) |
0.74 (0.63–0.87) |
0.79 (0.73–0.86) |
0.81 (0.72–0.90) |
0.061 | 55.0 (0.038) | <0.001 | <0.001 | 0.49–1.11 | No | Yes | Suggestive |
| Xie 2017 | Obs | 5 | 1989 | - | 0.63 (0.54–0.74) |
0.63 (0.54–0.74) |
0.66 (0.55–0.80) |
0.200 | 0.0 (0.680) | <0.001 | <0.001 | 0.48–0.82 | No | Yes | Convincing |
| Zhong 2015 (post-diagnostic) |
Obs | 2 | 276 | 0.39 (0.22–0.71) |
0.39 (0.22–0.71) |
0.39 (0.22–0.71) |
0.24 (0.07–0.87) |
- | 0.0 (0.395) | 0.002 | 0.002 | NA | - | Yes | - |
| Pancreatic Cancer | |||||||||||||||
| Jian-Yu 2018 | Overall | 6 | 12,057 | 0.75 (0.59–0.90) |
0.81 (0.69–0.95) |
0.92 (0.87–0.97) |
0.94 (0.89–1.01) |
0.008 | 81.1 (<0.001) | 0.009 | 0.001 | 0.52–1.26 | Yes | No | Weak |
| Prostate Cancer | |||||||||||||||
| Mei 2017 | Cohort | 10 | 73,716 | 0.72 (0.63–0.81) |
0.72 (0.63–0.81) |
0.89 (0.87–0.91) |
0.79 (0.76–0.82) |
0.044 | 95.0 (<0.001) | <0.001 | <0.001 | 0.46–1.12 | Yes | Yes | Weak |
| Meng 2016 (post-diagnostic) | Obs | 7 | 58,838 | 0.84 (0.71–0.99) |
0.77 (0.68–0.86) |
0.80 (0.76–0.83) |
0.79 (0.75–0.83) |
0.376 | 72.0 (0.002) | <0.001 | <0.001 | 0.54–1.09 | No | Yes | Suggestive * |
| Meng 2016 (pre-diagnostic) | Obs | 2 | 1337 | 0.56 (0.38–0.85) |
0.56 (0.38–0.83) |
0.56 (0.38–0.83) |
0.57 (0.38–0.85) |
- | 0.0 (0.770) | 0.004 | 0.004 | NA | - | Yes | - |
| Raval 2016 | Cohort | 6 | 31,539 | 0.76 (0.63–0.90) |
0.76 (0.63–0.91) |
0.80 (−0.75–0.86) |
0.86 (0.78–0.95) |
0.503 | 71.0 (0.004) | 0.004 | <0.001 | 0.44–1.29 | No | Yes | Weak |
| Luo 2015 | Obs | 5 | 22,439 | 0.82 (0.70–0.97) |
0.83 (0.70–0.97) |
0.85 (0.78–0.93) |
0.86 (0.78–0.95) |
0.461 | 46.0 (0.110) | 0.022 | <0.001 | 0.52–1.31 | No | Yes | Suggestive |
| Zhong 2015 (post-diagnostic) |
Obs | 3 | 18,814 | 0.59 (0.35–0.99) |
0.59 (0.34–1.01) |
0.82 (0.75–0.90) |
0.86 (0.78–0.95) |
0.228 | 84.1 (0.001) | 0.053 | <0.001 | 0.00–406.64 | No | No | Non-significant |
| Urothelial Tract Cancer | |||||||||||||||
| Zhong 2015 (post-diagnostic) |
Obs | 5 | 9488 | 0.87 (0.75–1.00) |
0.87 (0.75–1.00) |
0.87 (0.79–0.95) |
0.89 (0.71–1.12) |
0.917 | 52.8 (0.070) | 0.049 | 0.001 | 0.56–1.34 | No | No | Weak |
ES, Effect size; CI, Confidence interval; PI, Prediction interval; Obs, Observational study. § Risk ratio (95% Confidence interval) of the largest study in each meta-analysis. † I2 metric of inconsistency (95% confidence interval of I2) and P-value of the Cochran Q test for evaluation of heterogeneity. * Convincing or suggestive level of evidence due to the greater number of studies that decrease risk.