Table 2.
Summary of each individual meta-analysis on associations of the use of statin and cancer-specific 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 | 2 | 2619 | 1.06 (0.87–1.29) |
1.06 (0.87–1.29) |
1.06 (0.87–1.29) |
1.04 (0.84–1.28) |
- | 0.0 (0.590) | 0.559 | 0.559 | NA | - | Yes | Non-significant |
| Breast cancer | |||||||||||||||
| Liu 2017 | Cohort | 8 | 196,120 | 0.73 (0.59–0.92) |
0.73 (0.58–0.92) |
0.73 (0.67–0.78) |
0.85 (0.74–0.98) |
0.997 | 85.6 (<0.001) | 0.007 | <0.001 | 0.34–1.58 | No | Yes | Weak |
| Manthravadi 2016 | Cohort | 6 | 46,970 | 0.30 (0.46–1.06) |
0.69 (0.45–1.06) |
0.62 (0.54–0.71) |
0.35 (0.28–0.45) |
0.591 | 86.0 (<0.001) | 0.091 | <0.001 | 0.16–2.92 | No | No | Non-significant |
| Mansourian 2016 | Obs | 13 | 99,610 | 0.85 (0.83–0.87) |
0.85 (0.82–0.88) |
0.85 (0.83–0.87) |
0.83 (0.80–0.86) |
0.465 | 8.6 (0.360) | <0.001 | <0.001 | NA | No | Yes | - |
| Zhong 2015 (post-diagnostic) | Obs | 3 | 49,116 | 0.60 (0.41–0.88) |
0.60 (0.39–0.92) |
0.60 (0.52–0.69) |
0.47 (0.39–0.57) |
0.995 | 84.1 (<0.001) | 0.018 | <0.001 | 0.00–106.05 | No | Yes | Weak |
| Zhong 2015 (pre-diagnostic) | Obs | 4 | 88,235 | 0.73 (0.61–0.89) |
0.77 (0.68–0.87) |
0.77 (0.68–0.87) |
0.60 (0.35–1.01) |
0.002 | 21.5 (0.428) | <0.001 | <0.001 | 0.59–1.01 | Yes | No | Suggestive |
| Colorectal cancer | |||||||||||||||
| Gray 2016 (post-diagnostic) | Obs | 4 | 19,152 | 0.84 (0.68–1.04) |
0.84 (0.68–1.04) |
0.82 (0.75–0.91) |
0.90 (0.77–1.05) |
0.887 | 67.0 (0.030) | 0.118 | <0.001 | 0.36–2.00 | No | Yes | Non-significant |
| Gray 2016 (pre-diagnostic) | Obs | 6 | 86,622 | 0.82 (0.79–0.86) |
0.82 (0.79–0.86) |
0.82 (0.79–0.86) |
0.81 (0.75–0.88) |
0.152 | 0.0 (0.570) | <0.001 | <0.001 | NA | No | Yes | - |
| Ling 2015 (post-diagnostic) | Cohort | 3 | 8667 | 0.70 (0.60–0.81) |
0.70 (0.60–0.82) |
0.70 (0.60–0.82) |
0.71 (0.61–0.84) |
0.219 | 0.0 (0.535) | <0.001 | <0.001 | 0.26–1.87 | No | Yes | Suggestive |
| Ling 2015 (pre-diagnostic) | Cohort | 6 | 74,042 | 0.80 (0.77–0.84) |
0.80 (0.77–0.84) |
0.80 (0.77–0.84) |
0.79 (0.74–0.85) |
0.231 | 10.8 (0.347) | <0.001 | <0.001 | 0.74–0.88 | No | Yes | Convincing |
| Cai 2015 (pre&post-diagnostic) | Obs | 6 | 69,949 | 0.80 (0.75–0.85) |
0.80 (0.75–0.85) |
0.80 (0.77–0.85) |
0.79 (0.74–0.85) |
0.172 | 19.3 (0.288) | <0.001 | <0.001 | 0.71–0.90 | No | Yes | Convincing |
| Cai 2015 (post-diagnostic) | Obs | 3 | 15,023 | 0.70 (0.60–0.81) |
0.70 (0.60–0.82) |
0.70 (0.60–0.82) |
0.71 (0.61–0.84) |
0.219 | 0.0 (0.535) | <0.001 | <0.001 | 0.26–1.87 | No | Yes | Suggestive |
| Cai 2015 (pre-diagnostic) | Obs | 5 | 69,375 | 0.80 (0.74–0.86) |
0.80 (0.74–0.86) |
0.81 (0.77–0.85) |
0.79 (0.74–0.85) |
0.298 | 28.3 (0.233) | <0.001 | <0.001 | 0.67–0.95 | No | Yes | Convincing |
| Zhong 2015 (post-diagnostic) | Obs | 4 | 11,070 | 0.79 (0.58–1.08) |
0.79 (0.58–1.08) |
0.77 (0.67–0.88) |
0.71 (0.61–0.83) |
0.959 | 60.5 (0.058) | 0.141 | <0.001 | 0.24–2.65 | No | No | Weak |
| Zhong 2015 (pre-diagnostic) | Obs | 3 | 25,081 | 0.82 (0.73–0.91) |
0.82 (0.74–0.90) |
0.83 (0.78–0.89) |
0.77 (0.68–0.88) |
0.414 | 36.2 (0.239) | <0.001 | <0.001 | 0.31–2.19 | No | Yes | Suggestive |
| Endocrine gynecological cancer | |||||||||||||||
| Xie 2017 | Obs | 4 | 1079 | - | 0.75 (0.55–1.01) |
0.72 (0.58–0.90) |
0.74 (0.54–1.02) |
0.357 | 35.1 (0.202) | 0.057 | 0.004 | 0.27–2.09 | No | Yes | Non-significant |
| Kidney cancer | |||||||||||||||
| Nayan 2017 | Overall | 6 | 10,337 | 0.67 (0.47–0.94) |
0.67 (0.48–0.94) |
0.81 (0.71–0.93) |
0.85 (0.72–1.01) |
0.120 | 67.0 (0.010) | 0.022 | 0.003 | 0.25–1.82 | No | No | Weak |
| Luo 2015 | Obs | 2 | 3273 | 0.71 (0.35–1.50) |
0.72 (0.35–1.51) |
0.84 (0.64–1.11) |
1.02 (0.74–1.39) |
– | 82.0 (0.020) | 0.389 | 0.222 | NA | - | Yes | Non-significant |
| Ovarian cancer | |||||||||||||||
| Li 2018 | Obs | 3 | 27,690 | 0.87 (0.80–0.95) |
0.87 (0.80–0.95) |
0.87 (0.80–0.95) |
0.93 (0.81–1.08) |
0.577 | 0.0 (0.411) | 0.002 | 0.002 | 0.50–1.54 | No | No | Weak |
| Prostate cancer | |||||||||||||||
| Meng 2016 (post-diagnostic) | Obs | 4 | 57,058 | 0.64 (0.52–0.79) |
0.64 (0.52–0.79) |
0.73 (0.69–0.77) |
0.74 (0.70–0.79) |
0.254 | 82.0 (<0.001) | <0.001 | <0.001 | 0.27–1.55 | No | Yes | Suggestive * |
| Meng 2016 (pre-diagnostic) | Obs | 6 | 35,684 | 0.53 (0.29–0.98) |
0.54 (0.37–0.78) |
0.78 (0.72–0.84) |
0.81 (0.75–0.88) |
0.019 | 77.0 (<0.001) | 0.001 | <0.001 | 0.18–1.64 | Yes | Yes | Weak |
| Raval 2016 | Cohort | 5 | 21,306 | 0.76 (0.64–0.89) |
0.76 (0.64–0.89) |
0.76 (0.69–0.84) |
0.76 (0.66–0.88) |
0.593 | 30.0 (0.150) | 0.001 | <0.001 | 0.49–1.17 | No | Yes | Suggestive |
| Luo 2015 | Obs | 7 | 28,897 | 0.70 (0.59–0.83) |
0.70 (0.60–0.83) |
0.74 (0.68–0.82) |
0.76 (0.66–0.88) |
0.011 | 43.0 (0.100) | <0.001 | <0.001 | 0.48–1.04 | Yes | Yes | Suggestive |
| Zhong 2015 (post-diagnostic) | Obs | 3 | 19,322 | 0.77 (0.70–0.85) |
0.77 (0.70–0.85) |
0.77 (0.70–0.85) |
0.76 (0.66–0.88) |
0.973 | 0.0 (0.970) | <0.001 | <0.001 | 0.38–1.54 | No | Yes | Suggestive |
| Zhong 2015 (pre-diagnostic) | Obs | 3 | 5460 | 0.44 (0.20–0.93) |
0.44 (0.21–0.92) |
0.72 (0.62–0.82) |
0.78 (0.67–0.90) |
0.148 | 86.3 (0.001) | 0.029 | <0.001 | Not estimable | No | Yes | Suggestive * |
| Urothelial tract cancer | |||||||||||||||
| Zhong 2015 (post-diagnostic) | Obs | 4 | 6880 | 0.86 (0.65–1.16) |
0.87 (0.66–1.14) |
0.87 (0.76–1.01) |
0.86 (0.72–1.03) |
0.901 | 61.8 (0.073) | 0.307 | 0.070 | 0.30–2.53 | No | Yes | Non-significant |
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.