Group Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA 98101, USA.
Expert Opin Drug Saf. 2010 Jul;9(4):603-21. doi: 10.1517/14740331003662620.
HMG-CoA inhibitors (statins), a class of drugs that reduce cholesterol, are used to manage and prevent coronary heart disease. They are among the most commonly prescribed drugs worldwide. Contrary to early concerns over the carcinogenicity of statins, a growing body of evidence suggests statins may in fact have a chemopreventive potential against cancer.
In this paper, we review evidence on the association between statin use and cancer risk. Specifically, we report on clinical trials and observational studies that measured all cancer or site-specific cancers of the breast, colorectal, lung, prostate and reproductive organs associated with statin use.
An understanding of the evidence, including strengths and limitations, to support an association between statins and cancer. Information on the current state of the field and future directions are also discussed.
Few strong or consistent associations between statins and cancer incidence overall or for any of the sites reviewed were detected. Data for any effects of statins on cancer prognosis and secondary prevention are lacking; with the exception of consistent evidence that statins are associated with reduced risk of advanced/aggressive prostate cancer. Statins appear safe in relation to cancer risk but any chemopreventive effect in humans remains to be established and should not be recommended outside the context of clinical trials. It is encouraging that numerous trials are ongoing. The prospect of reducing the incidence and burden of some of the most prevalent cancers with safe, affordable and tolerable medication that already reduces the risk of the leading cause of death and cardiovascular disease warrants further exploration in clinical trials and observational studies of prognosis and survival.
HMG-CoA 抑制剂（他汀类药物），一类降低胆固醇的药物，用于治疗和预防冠心病。它们是世界上最常用的药物之一。与早期对他汀类药物致癌性的担忧相反，越来越多的证据表明，他汀类药物实际上可能具有抗癌的化学预防潜力。
在本文中，我们回顾了他汀类药物使用与癌症风险之间关联的证据。具体来说，我们报告了临床试验和观察性研究的结果，这些研究测量了所有癌症或与他汀类药物使用相关的乳腺癌、结直肠癌、肺癌、前列腺癌和生殖器官的特定部位癌症。
了解支持他汀类药物与癌症之间关联的证据，包括其优势和局限性。还讨论了该领域的现状和未来方向。
总体而言，或在审查的任何部位，都很少发现他汀类药物与癌症发病率之间存在强烈或一致的关联。缺乏关于他汀类药物对癌症预后和二级预防影响的数据；除了一致的证据表明他汀类药物与降低晚期/侵袭性前列腺癌风险有关外。他汀类药物在癌症风险方面似乎是安全的，但在临床试验之外，任何人类的化学预防作用仍有待确定，不应推荐使用。令人鼓舞的是，许多试验正在进行中。用已经降低主要死因和心血管疾病风险的安全、负担得起且可耐受的药物来降低一些最常见癌症的发病率和负担的前景，值得在临床试验和预后及生存的观察性研究中进一步探索。
