How can statins help you? What the research says

Statins are cholesterol-lowering drugs that some integrativein cancer care, a patient-centered approach combining the best of conventional care, self care, and evidence-informed complementary care in an integrated plan oncologists use off-label to improve survival, although statins can have serious side effects.

How can statins help you? What the research says

Statins are classified as either more hydrophilic (tending to combine with or dissolve in water) or more lipophilic (tending to combine with or dissolve in lipids or fats). The more lipophilic statins have been associated with stronger anticancer effects and cancer prevention in some but not all situations.

Lipophilic statins:

Lovastatin
Simvastatin
Atorvastatin

Fluvastatin
Pitavastatin

Hydrophilic statins:

Pravastatin

Rosuvastatin

Commentary on statins in cancer care

Nancy Hepp, MS, CancerChoices lead researcher: While hundreds of studies on the effects of statins on cancer risk and outcomes have been published, we found that many important questions have not been addressed. For example, we suspect that the role of statins in improving some cancer outcomes may relate to their effects on inflammation. Health professionals have drawn links between cholesterol—which statins are used to manage—and inflammation,¹Satny M, Hubacek JA, Vrablik M. Statins and inflammation. Current Atherosclerosis Reports. 2021 Dec 1;23(12):80. although we may not yet know the full extent of the link.

Unfortunately, most studies have not reported both effects on cancer outcomes and on inflammation, so we cannot assess whether better outcomes may be tied to less inflammation. If it is, then we might conclude that anybody with inflammation might benefit from statins, and that people without inflammation may not see any benefit. This could be one reason that different types of studies find different results. Some studies may include more people with high cholesterol and its related inflammation. Statins can also increase blood glucose (diabetogenic effect),²Casula M, Mozzanica F et al. Statin use and risk of new-onset diabetes: a meta-analysis of observational studies. Nutrition, Metabolism, and Cardiovascular Disease. 2017 May;27(5):396-406. and people who are vulnerable to this complication may see more inflammation, not less. Knowing more precisely who may benefit from statins would also help oncologists avoid bringing the potential unpleasant side effects of statins to people who aren’t likely to find much benefit.

Other questions we have that have not been answered in research so far:

Do the different classes of statins—hydrophilic versus lipophilic—have the same effects on cancer outcomes and risk? Some evidence shows more benefit from one class or the other for different cancer types, but not enough research has been done to answer this question.
Are the same effects found from individual statins within the same class?

We summarize the clinical evidence for each medical benefit here. We begin with our assessment of the strength of evidence within each category, followed by a brief summary of individual studies or reviews of several studies. In assessing the strength of evidence, we consider the study design, number of participants, and the size of the treatment effect (how much outcomes changed with treatment).

To see more details, click the plus sign to the right of any section.

Our assessments of evidence for each medical benefit fall into one of these categories:

Strong evidence: consistent, significant effects in several large (or at least one very large) well designed clinical studies or at least two meta-analysesa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of clinical studies of moderate or better quality (or one large meta-analysis) finding similar results
Good evidence: significant effects in one large or several mid-sized and well-designed clinical studies ( randomized controlled trialsa study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects with an appropriate placebo or other strong comparison control or observational studies that control for confounds)
Modest evidence: significant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods studies), or several small studies aggregated into a meta-analysis
Preliminary evidence: significant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect
Weak evidence: one or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects
Insufficient evidence: preclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example)

Learn more about how we research and rate therapies and practices in How We Rate Therapies ›

Improving treatment outcomes

Are statins linked to improved survival? Are they linked to less cancer growth or metastasis? Do they enhance the anticancer action of other treatments or therapies? We present the evidence.

Commentary on statins’ impact on cancer outcomes

Nancy Hepp, MS, CancerChoices lead researcher: Many studies of statins are observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods, following people who are already taking statins to lower cholesterol and prevent heart disease. Users of statins tend to be older individuals with cardiovascular diseases or diabetes and are more likely to be overweight and/or to smoke compared to patients who start taking statins only after a cancer diagnosis. These characteristics may explain why people who use a statin only after a cancer diagnosis have better survival than people who were using statins before diagnosis in some analyses—they may have been healthier at the time of their cancer diagnosis.³Mei Z, Liang M et al. Effects of statins on cancer mortality and progression: a systematic review and meta-analysis of 95 cohorts including 1,111,407 individuals. International Journal of Cancer. 2017 Mar 1;140(5):1068-1081. To assess statins’ effects on cancer outcomes, we report cancer-specific survival instead of overall survival when possible.

You’ll see many places in the evidence below that observational studies found different results than randomized controlled trials (RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects) of statins. Observational studies cannot determine cause and effect, while RCTs are better at determining causal relationships. This is why researchers favor findings from RCTs over observational studies. However, RCTs typically exclude people who have used statins and may even exclude people who have high cholesterol or cardiovascular disease. This makes for a substantial difference between observational studies compared to RCTs regarding the health status of people being assessed—called the study population. We don’t know whether the difference in the results is due to the difference in study design or the difference in the health status of the study populations.

Cancer as a whole

People treated with statins do not show any benefit on cancer survival in more rigorous trials, but substantial observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods research has found better survival among people with cancer using statins for other health conditions.

Also see evidence related to advanced cancer as a whole in Advanced cancer below.

Use before a cancer diagnosis or unspecified timing

RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects: no evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on progression-free survivalthe time during and after treatment of a disease that a patient lives without disease progression (worsening), overall response rates, or cancer-specific mortality among people with cancer treated with statins in combined analyses of RCTs

No evidence of an effect on progression-free survival (4 studies) or overall response rates (6 studies) among people with cancer (colorectal, liver, lung, or stomach) treated with statins compared to no statins in meta-analysesstatistical analyses that combine the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of RCTs⁴Benjamin DJ, Haslam A, Prasad V. Cardiovascular/anti-inflammatory drugs repurposed for treating or preventing cancer: a systematic review and meta-analysis of randomized trials. Cancer Medicine. 2024 Mar;13(5):e7049.
No evidence of an effect on cancer-specific mortality among people with cancer treated with statins before a cancer diagnosis compared with no statins in 18 meta-analyses of RCTs⁵He Y, Li X et al. Statins and multiple noncardiovascular outcomes: umbrella review of meta-analyses of observational studies and randomized controlled trials. Annals of Internal Medicine. 2018 Oct 16;169(8):543-553.

Observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods studies

13% lower cancer-specific mortality but no evidence of an effect on progression-free survival among people with cancer treated with statins compared to no statins in a large meta-analysis of 23 observational studies⁶Yang J, Li C et al. Impact of statin use on cancer-specific mortality and recurrence: a meta-analysis of 60 observational studies. Medicine (Baltimore). 2020 Apr;99(14):e19596.
22% lower cancer-specific mortality (39 studies) but no evidence of an effect on progression-free survival (13 studies) among people with cancer treated with statins compared to no statins in large meta-analyses of observational studies⁷Yang J, Li C et al. Impact of statin use on cancer-specific mortality and recurrence: a meta-analysis of 60 observational studies. Medicine (Baltimore). 2020 Apr;99(14):e19596.
Lower cancer-specific mortality among people with cancer treated with statins before a cancer diagnosis compared with no use in an umbrella review of 22 observational studies⁸He Y, Li X et al. Statins and multiple noncardiovascular outcomes: umbrella review of meta-analyses of observational studies and randomized controlled trials. Annals of Internal Medicine. 2018 Oct 16;169(8):543-553.
40% lower cancer-specific mortality and 33% lower risk of progression among people with cancer using statins compared to no statins in a very large meta-analysis of 55 observational studies⁹Mei Z, Liang M et al. Effects of statins on cancer mortality and progression: a systematic review and meta-analysis of 95 cohorts including 1,111,407 individuals. International Journal of Cancer. 2017 Mar 1;140(5):1068-1081.
31% lower cancer-specific mortality among people using statins before diagnosis in a very large meta-analysis of 41 observational studies¹⁰Zhong S, Zhang X et al. Statin use and mortality in cancer patients: systematic review and meta-analysis of observational studies. Cancer Treatment Reviews. 2015 Jun;41(6):554-67.

Good evidence of better overall and progression-free survival after treatment with immune checkpoint inhibitors among people with cancer treated with statins

Better overall survival and progression-free survival after treatment with immune checkpoint inhibitors among people with cancer treated with statins compared to no statins in a meta-analysis of 5 observational studies¹¹Zhang Y, Chen H et al. The effect of concomitant use of statins, NSAIDs, low-dose aspirin, metformin and beta-blockers on outcomes in patients receiving immune checkpoint inhibitors: a systematic review and meta-analysis. Oncoimmunology. 2021 Aug 2;10(1).
Better progression-free survival after treatment with immune checkpoint inhibitors (ICIs) among people with solid tumors or blood cancer treated with statins during ICI treatment compared to no statins in a meta-analysis of 6 observational studies¹²Zhang Y, Chen H et al. The effect of concomitant use of statins, NSAIDs, low-dose aspirin, metformin and beta-blockers on outcomes in patients receiving immune checkpoint inhibitors: a systematic review and meta-analysis. Oncoimmunology. 2021 Aug 2;10(1).

Statin use after a cancer diagnosis

Good but somewhat conflicting evidence of lower cancer-specific mortality among people with cancer treated with statins after diagnosis

23% lower cancer-specific mortality among people with cancer treated with statins after diagnosis in a very large meta-analysis of 41 observational studies¹³Zhong S, Zhang X et al. Statin use and mortality in cancer patients: systematic review and meta-analysis of observational studies. Cancer Treatment Reviews. 2015 Jun;41(6):554-67.
No evidence of an effect on cancer-specific mortality among people with cancer initiating statin treatment within 6 months after a cancer diagnosis compared to no statins in a very large observational study free of selection bias and immortal-time bias¹⁴Emilsson L, García-Albéniz X et al. Examining bias in studies of statin treatment and survival in patients with cancer. JAMA Oncology. 2018 Jan 1;4(1):63-70. Erratum in: JAMA Oncology. 2018 Jan 1;4(1):133.

Advanced cancer

People with advanced prostate or pancreatic cancer have seen better survival when using statins. No other types of advanced cancer have shown survival benefit from statins.

Advanced cancer as a whole: no evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on overall survival or progression-free survivalthe time during and after treatment of a disease that a patient lives without disease progression (worsening) among people with advanced cancer and a prognosis less than 2 years treated with statins in a combined analysis of studies

No evidence of an effect on overall survival (10 studies) or progression-free survival (9 studies) among people with advanced cancer and a prognosis less than 2 years treated with statins compared to controls in meta-analysesstatistical analyses that combine the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects¹⁵Farooqi MAM, Malhotra N et al. Statin therapy in the treatment of active cancer: a systematic review and meta-analysis of randomized controlled trials. PLoS One. 2018 Dec 20;13(12):e0209486.

Advanced colorectal cancer: no evidence of an effect on progression-free or overall survival among people with previously treated metastatic colorectal cancer treated with simvastatin in 1 study

No evidence of an effect on progression-free or overall survival after FOLFIRI/XELIRI treatment among people with previously treated metastatic colorectal cancer treated with 40 mg simvastatin compared to placeboa pill, medicine, or procedure—thought to be both harmless and ineffective—prescribed for the psychological benefit to the patient or as a sham treatment in a study to allow a comparison to a therapy of interest in a mid-sized RCT¹⁶Lim SH, Kim TW et al. A randomised, double-blind, placebo-controlled multi-centre phase III trial of XELIRI/FOLFIRI plus simvastatin for patients with metastatic colorectal cancer. British Journal of Cancer. 2015 Nov 17;113(10):1421-6.

Advanced liver cancer: no evidence of an effect on overall survival among people with advanced hepatocellular carcinoma treated with pravastatin in 1 study

No evidence of an effect on overall survival during almost 3 years of follow up after treatment with sorafenib among people with advanced hepatocellular carcinoma treated with pravastatin compared to sorafenib alone in a mid-sized RCT¹⁷Jouve JL, Lecomte T et al; PRODIGE-11 investigators/collaborators. Pravastatin combination with sorafenib does not improve survival in advanced hepatocellular carcinoma. Journal of Hepatology. 2019 Sep;71(3):516-522.

Advanced pancreatic cancer: modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of lower mortality and higher progression-free survival among people with metastatic pancreatic cancer treated with statins

Lower mortality and higher progression-free survival among people with metastatic pancreatic cancer treated with statins compared to no statins in a pooled analysis of two observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods studies¹⁸Abdel-Rahman O. Statin treatment and outcomes of metastatic pancreatic cancer: a pooled analysis of two phase III studies. Clinical and Translational Oncology. 2019 Jun;21(6):810-816.

Advanced prostate cancer: good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) of moderately lower mortality, including cancer-specific mortality, among people with advanced prostate cancer treated with statins, including during antiandrogen therapy

25% lower overall mortality among people with metastatic castration-resistant prostate cancer treated with statins compared to no statins in a meta-analysis of observational data from 3 RCTs¹⁹Joshua AM, Armstrong A et al. Statin and metformin use and outcomes in patients with castration-resistant prostate cancer treated with enzalutamide: a meta-analysis of AFFIRM, PREVAIL and PROSPER. European Journal of Cancer. 2022 Jul;170:285-295.
35% lower cancer-specific mortality among men with advanced prostate cancer undergoing androgen-ablative therapies (androgen deprivation or androgen receptor axis–targeted therapies) treated with statins after a cancer diagnosis compared to no statins in a very large meta-analysis of 14 observational studies²⁰Jayalath VH, Clark R et al. Statin use and survival among men receiving androgen-ablative therapies for advanced prostate cancer: a systematic review and meta-analysis. JAMA Network Open. 2022 Nov 1;5(11):e2242676.
46% lower overall mortality among people with metastatic castration-resistant prostate cancer using the antiandrogens enzalutamide or abiraterone treated with statins compared to no statins in a meta-analysis of 4 observational studies²¹Mariano R Jr, Tavares KL, Panhoca R, Sadi M. Influence of statins in metastatic castration-resistant prostate cancer patients treated with new antiandrogen therapies: a systematic review and meta-analysis. Einstein (Sao Paulo). 2022 Apr 1;20:eRW6339.
36% lower cancer-specific mortality among people with advanced prostate cancer using androgen deprivation therapy or abiraterone/enzalutamide treated with statins compared to no statins in a very large meta-analysis of 11 observational studies²²Yang H, Pang L et al. The effect of statins on advanced prostate cancer patients with androgen deprivation therapy or abiraterone/enzalutamide: a systematic review and meta-analysis. Journal of Clinical Pharmacy and Therapeutics. 2020 Jun;45(3):488-495.

Bladder and urothelial cancers

People with bladder or urothelial cancers have not seen a survival benefit from using statins.

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on cancer-specific mortality or progression-free survivalthe time during and after treatment of a disease that a patient lives without disease progression (worsening) among people with bladder cancer treated with statins in combined analyses of studies

No evidence of an effect on cancer-specific mortality (2 studies) or progression-free survival (2 studies) among people with bladder cancer treated with statins compared to no statins in meta-analysesstatistical analyses that combine the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods studies²³Luo Y, She DL, Xiong H, Fu SJ, Yang L. The prognostic effect of statin use on urologic cancers: an updated meta-analysis of 35 observational studies. Medicine (Baltimore). 2015 Sep;94(36):e1523.
No evidence of an effect on cancer-specific mortality among people with urothelial cancer treated with statins after diagnosis compared to no statins in a meta-analysis of 4 observational studies²⁴Zhong S, Zhang X et al. Statin use and mortality in cancer patients: systematic review and meta-analysis of observational studies. Cancer Treatment Reviews. 2015 Jun;41(6):554-67.

Brain cancer

People with brain cancers have not seen a survival benefit from using statins.

Breast cancer

People with breast cancer have seen a moderate cancer-specific survival benefit when treated with statins, although people with triple-negative breast cancer do not show a survival benefit from statins.

20% lower cancer-specific mortality among people with breast cancer treated with statins after a cancer diagnosis compared to no statins, with 15% lower cancer-specific mortality among people using lipophilic statins, in a very large meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 15 observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods studies²⁷Jaiswal V, Agrawal V et al. Post-diagnostic statin use and its association with cancer recurrence and mortality in breast cancer patients: a systematic review and meta-analysis. European Heart Journal. Cardiovasccular Pharmacotherapy. 2023 Dec 14;9(8):731-740.
18% lower cancer-specific mortality among people with breast cancer treated with statins in a meta-analysis of 17 observational studies and RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects²⁸Zhao G, Ji Y et al. Effect of statins use on risk and prognosis of breast cancer: a meta-analysis. Anticancer Drugs. 2022 Jan 1;33(1):e507-e518.
39% lower cancer-specific mortality among people with breast cancer treated with statins after a cancer diagnosis compared to no statins, with 26% lower cancer-specific mortality among people with hormone receptor-positive cancer in a large meta-analysis of 7 observational studies²⁹Xu WH, Zhou YH. The relationship between post-diagnostic statin usage and breast cancer prognosis varies by hormone receptor phenotype: a systemic review and meta-analysis. Archives of Gynecology and Obstetrics. 2021 Nov;304(5):1315-1321.
8% lower cancer-specific mortality among females with breast cancer with each additional 10% adherence to 1-year of lipid-lowering medications, with stronger benefits from lipophilic compared to hydrophilic statins in a large observational study³⁰Feng JL, Qin X. Does adherence to lipid-lowering medications improve cancer survival? A nationwide study of breast and colorectal cancer, and melanoma. British Journal of Clinical Pharmacology. 2021 Apr;87(4):1847-1858.
21% lower cancer-specific mortality among people with breast cancer treated with statins compared to no statins in a meta-analysis of 7 observational studies³¹Yang J, Li C et al. Impact of statin use on cancer-specific mortality and recurrence: a meta-analysis of 60 observational studies. Medicine (Baltimore). 2020 Apr;99(14):e19596.
27% lower cancer-specific mortality during up to 4 years of follow up among people with breast cancer treated with statins, with stronger effects with lipophilic statins, compared to no statins in a very large meta-analysis of 8 observational studies³²Liu B, Yi Z, Guan X, Zeng YX, Ma F. The relationship between statins and breast cancer prognosis varies by statin type and exposure time: a meta-analysis. Breast Cancer Research and Treatment. 2017 Jul;164(1):1-11.
30% lower cancer-specific mortality among people with breast cancer treated with statins compared to no statins in a meta-analysis of 6 observational studies³³Manthravadi S, Shrestha A, Madhusudhana S. Impact of statin use on cancer recurrence and mortality in breast cancer: a systematic review and meta-analysis. International Journal of Cancer. 2016 Sep 15;139(6):1281-8.
15% lower cancer-specific mortality among people with breast cancer treated with statins compared to no statins in a large meta-analysis of 4 observational studies³⁴Mansourian M, Haghjooy-Javanmard S et al. Statins use and risk of breast cancer recurrence and death: a systematic review and meta-analysis of observational studies. Journal of Pharmacy and Pharmaceutical Sciences. 2016;19(1):72-81.
35% lower risk of cancer-specific mortality among people with breast cancer treated with statins after a cancer diagnosis in a large meta-analysis of 4 observational studies³⁵Wu QJ, Tu C et al. Statin use and breast cancer survival and risk: a systematic review and meta-analysis. Oncotarget. 2015 Dec 15;6(40):42988-3004.
40% lower cancer-specific mortality among people with breast cancer treated with statins after diagnosis and 23% lower cancer-specific mortality with use before diagnosis compared to no statins in a large meta-analysis of 3 observational studies³⁶Zhong S, Zhang X et al. Statin use and mortality in cancer patients: systematic review and meta-analysis of observational studies. Cancer Treatment Reviews. 2015 Jun;41(6):554-67.
28% lower disease-specific mortality among people with breast cancer treated with statins before a cancer diagnosis in a meta-analysis of 3 observational studies³⁷Wu QJ, Tu C et al. Statin use and breast cancer survival and risk: a systematic review and meta-analysis. Oncotarget. 2015 Dec 15;6(40):42988-3004.

Triple-negative breast cancer: no evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on overall 5-year survival after cancer treatment among people with triple-negative breast cancer treated with statins in a combined analysis of studies

No evidence of an effect on overall survival at 5 years after oncologic treatment for curative intent among people with triple negative breast cancer treated with statins compared to no statins in a meta-analysis of 5 observational studies³⁸McKechnie T, Brown Z et al. Concurrent use of statins in patients undergoing curative intent treatment for triple negative breast cancer: a systematic review and meta-analysis. Clinical Breast Cancer. 2024 Apr;24(3):e103-e115.

Better markers of proliferation (lower cyclin D1 and higher protein expression of the tumor suppressor p27) in tumors from people with primary invasive breast cancer treated with 80 mg atorvastatin a day for 2 weeks before surgery compared to baseline in a small uncontrolled triala study in which a therapy is used, but without a comparison group against which to judge outcomes; an uncontrolled trial is considered a weak study design³⁹Feldt M, Bjarnadottir O et al. Statin-induced anti-proliferative effects via cyclin D1 and p27 in a window-of-opportunity breast cancer trial. Journal of Translational Medicine. 2015 Apr 29;13:133.

Colorectal cancer

People with colorectal cancer treated with statins show lower cancer-specific mortality, although statin use has not had any effect on 30-day survival after surgery for colorectal cancer.

Also see evidence regarding advanced colorectal cancer above in Advanced cancer.

Statin use at any time: good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) of moderately lower cancer-specific mortality among people with colorectal cancer treated with statins

8% lower cancer-specific mortality among females with colorectal cancer with each additional 10% adherence to 1-year of lipid-lowering medications, with stronger benefits from lipophilic compared to hydrophilic statins in a large observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods study⁴⁰Feng JL, Qin X. Does adherence to lipid-lowering medications improve cancer survival? A nationwide study of breast and colorectal cancer, and melanoma. British Journal of Clinical Pharmacology. 2021 Apr;87(4):1847-1858.
24% lower cancer-specific mortality among people with colorectal cancer treated with statins compared to no statins in a large meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 7 observational studies⁴¹Yang J, Li C et al. Impact of statin use on cancer-specific mortality and recurrence: a meta-analysis of 60 observational studies. Medicine (Baltimore). 2020 Apr;99(14):e19596.
27% lower overall mortality among people treated with glucose-lowering drugs and with colorectal cancer and ever treated with statins compared to no statins in a large observational study⁴²Zanders MM, van Herk-Sukel MP et al. Are metformin, statin and aspirin use still associated with overall mortality among colorectal cancer patients with diabetes if adjusted for one another? British Journal of Cancer. 2015 Jul 28;113(3):403-10.

Statin use before a cancer diagnosis: good evidence of moderately lower cancer-specific mortality among people with colorectal cancer treated with statins before a cancer diagnosis

18% lower cancer-specific mortality among people with colorectal cancer treated with statins before a cancer diagnosis compared to no statins in a very large meta-analysis of 5 observational studies⁴³Li Y, He X, Ding Y, Chen H, Sun L. Statin uses and mortality in colorectal cancer patients: An updated systematic review and meta-analysis. Cancer Medicine. 2019;8(6):3305–3313.
18% lower cancer-specific mortality among people with colorectal cancer treated with statins before a cancer diagnosis compared to no statins in large meta-analyses of 6 observational studies⁴⁴Gray RT, Coleman HG, Hughes C, Murray LJ, Cardwell CR. Statin use and survival in colorectal cancer: results from a population-based cohort study and an updated systematic review and meta-analysis. Cancer Epidemiology. 2016 Dec;45:71-81.
20% lower cancer-specific mortality among people with colorectal cancer treated with statins before cancer diagnosis compared to no statins in a meta-analysis of 6 observational studies⁴⁵Ling Y, Yang L et al. Prognostic significance of statin use in colorectal cancer: a systematic review and meta-analysis. Medicine (Baltimore). 2015 Jun;94(25):e908.
20% lower cancer-specific mortality among people with colorectal cancer treated with statins before diagnosis compared to no statins in large meta-analyses of 5 observational studies⁴⁶Cai H, Zhang G, Wang Z, Luo Z, Zhou X. Relationship between the use of statins and patient survival in colorectal cancer: a systematic review and meta-analysis. PLoS One. 2015 Jun 1;10(6):e0126944.
18% lower cancer-specific mortality among people with colorectal cancer treated with statins before a cancer diagnosis compared to no statins in a meta-analysis of 3 observational studies⁴⁷Zhong S, Zhang X et al. Statin use and mortality in cancer patients: systematic review and meta-analysis of observational studies. Cancer Treatment Reviews. 2015 Jun;41(6):554-67.

Beginning statins after a cancer diagnosis: modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of moderately higher survival among people with colorectal cancer treated with statins beginning after a cancer diagnosis

21% lower cancer-specific mortality among people with colorectal cancer treated with statins only after diagnosis compared to no statins in a very large meta-analysis of 8 observational studies⁴⁸Li Y, He X, Ding Y, Chen H, Sun L. Statin uses and mortality in colorectal cancer patients: An updated systematic review and meta-analysis. Cancer Medicine. 2019;8(6):3305–3313.
A weak trendan apparent change due to a therapy, close to but not achieving full statistical significance (this is the CancerChoices definition; other researchers and studies may define this differently toward lower cancer-specific mortality among people with colorectal cancer treated with statins after diagnosis compared to no statins in a large meta-analysis of 4 observational studies⁴⁹Gray RT, Coleman HG, Hughes C, Murray LJ, Cardwell CR. Statin use and survival in colorectal cancer: results from a population-based cohort study and an updated systematic review and meta-analysis. Cancer Epidemiology. 2016 Dec;45:71-81.
30% lower cancer-specific mortality among people with colorectal cancer treated with statins only after diagnosis compared to no statins in a meta-analysis of 3 observational studies⁵⁰Ling Y, Yang L et al. Prognostic significance of statin use in colorectal cancer: a systematic review and meta-analysis. Medicine (Baltimore). 2015 Jun;94(25):e908.
30% lower cancer-specific mortality but no evidence of an effect on disease-free survival among people with colorectal cancer treated with statins after a cancer diagnosis compared to no statins in a meta-analysis of 4 observational studies⁵¹Cai H, Zhang G, Wang Z, Luo Z, Zhou X. Relationship between the use of statins and patient survival in colorectal cancer: a systematic review and meta-analysis. PLoS One. 2015 Jun 1;10(6):e0126944.
A weak trend toward lower cancer-specific mortality among people with colorectal cancer treated with statins after diagnosis compared to no statins in a meta-analysis of 4 observational studies⁵²Zhong S, Zhang X et al. Statin use and mortality in cancer patients: systematic review and meta-analysis of observational studies. Cancer Treatment Reviews. 2015 Jun;41(6):554-67.

Mortality after surgery: no evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on 30-day mortality after surgery for colorectal cancer among people treated with statins in a large study

No evidence of an effect on 30-day mortality after surgery for colorectal cancer among people treated with statins compared to no statins in a very large observational study⁵³Fransgaard T, Thygesen LC, Gögenur I. Statin use is not associated with improved 30-day survival in patients undergoing surgery for colorectal cancer. International Journal of Colorectal Disease. 2018 Feb;33(2):199-207.

Gastrointestinal cancer

People with esophageal, liver, or stomach cancer have all shown moderately lower cancer-specific mortality when treated with statins.

Esophageal cancer

Good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) of moderately lower cancer-specific mortality among people with esophageal cancer treated with statins in observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods studies

23% lower cancer-specific mortality among people with esophageal cancer treated with statins compared to no statins in a large meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 7 observational studies⁵⁴Lv J, Chen P, Wu J, Wen Z, Zhao C. The association between statin use and prognosis in esophageal cancer patients: a meta-analysis. Medicine (Baltimore). 2023 Mar 24;102(12):e33359.
16% lower overall mortality among people with esophageal cancer—both esophageal adenocarcinoma and esophageal squamous cell carcinoma—treated with statins in a large meta-analysis of 5 observational studies⁵⁵Zhou C, Zhong X et al. Statin use and its potential therapeutic role in esophageal cancer: a systematic review and meta-analysis. Cancer Management and Research. 2019 Jun 19;11:5655-5663.
16% lower cancer-specific mortality among people with esophageal cancer—both esophageal adenocarcinoma and esophageal squamous cell carcinoma—treated with statins after a cancer diagnosis (4 studies), and 15% lower mortality with statin use before diagnosis (3 studies), compared to no statins in large meta-analyses of observational studies⁵⁶Deng HY, Lan X et al. The association between statin use and survival of esophageal cancer patients: a systematic review and meta-analysis. Medicine (Baltimore). 2019 Jul;98(29):e16480.

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on overall survival after esophagectomy among people with esophageal adenocarcinoma treated with simvastatin in a small study

No evidence of an effect on overall survival after esophagectomy among people with esophageal adenocarcinoma treated with 40 mg simvastatin for up to 1 year compared to placeboa pill, medicine, or procedure—thought to be both harmless and ineffective—prescribed for the psychological benefit to the patient or as a sham treatment in a study to allow a comparison to a therapy of interest in a small RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects⁵⁷Alexandre L, Clark AB et al. Adjuvant statin therapy for oesophageal adenocarcinoma: the STAT-ROC feasibility study. BJS Open. 2020 Feb;4(1):59-70.

Liver cancer

Good evidence of moderately lower cancer-specific mortality among people with liver cancer treated with statins

Also see information regarding advanced liver cancer above in Advanced cancer.

22% lower cancer-specific mortality among people with liver cancer (hepatocellular carcinoma) treated with statins compared to no statins in a large meta-analysis of 11 observational studies⁵⁸Li X, Liu L, Hu Y. Statin use and the prognosis of patients with hepatocellular carcinoma: a meta-analysis. Bioscience Reports. 2020 Apr 30;40(4):BSR20200232.
38% lower overall mortality among people with liver cancer (hepatocellular carcinoma) and chronic hepatitis B virus or hepatitis C virus treated with lipophilic statins after a hepatitis diagnosis and 12% lower mortality among people treated with hydrophilic statins compared to no statins in a very large observational study⁵⁹Simon TG, Duberg AS et al. Lipophilic statins and risk for hepatocellular carcinoma and death in patients with chronic viral hepatitis: results from a nationwide Swedish population. Annals of Internal Medicine. 2019 Sep 3;171(5):318-327.

Stomach cancer

Good evidence of moderately lower cancer-specific mortality among people with stomach cancer treated with statins

30% lower cancer-specific mortality among people with stomach (gastric) cancer treated with statins compared to no statins in meta-analyses of 7 observational studies⁶⁰Chen Y, Zhang J, Zhang Y, Zhu L. Effect of statin use on risk and mortality of gastric cancer: a meta-analysis. Anticancer Drugs. 2023 Sep 1;34(8):901-909.
37% lower overall mortality among people with stomach (gastric) cancer treated with statins compared to no statins in 5 retrospective studies but no evidence of an effect in 1 prospective study in a meta-analysis of 6 observational studies⁶¹Yuan M, Han S et al. Statins are associated with improved survival of patients with gastric cancer: a systematic review and meta-analysis. International Journal of Clinical Practice. 2022 May 17;2022:4938539.
22% lower overall mortality among people with stomach (gastric) cancer treated with statins compared to no statins in a meta-analysis of 13 observational studies⁶²Lou D, Fu R, Gu L, Su H, Guan L. Association between statins’ exposure with incidence and prognosis of gastric cancer: an updated meta-analysis. Expert Review of Clinical Pharmacology. 2022 Sep;15(9):1127-1138.

Gynecologic cancer

Ovarian cancer is listed separately.

People with endometrial or cervical cancer treated with statins have shown moderately better cancer-specific and progression-free survivalthe time during and after treatment of a disease that a patient lives without disease progression (worsening), with some evidence that treatment after cancer diagnosis and hydrophilic statins are each more effective with endometrial cancer.

Gynecologic cancer as a whole: modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of lower cancer-specific mortality and better progression-free survival among people with endocrine-related gynecologic cancer (endometrial and ovarian) treated with statins

28% lower cancer-specific mortality (4 studies) and 32% better progression-free survival (3 studies) among people with endocrine-related gynecologic cancer (endometrial and ovarian) treated with statins compared to no statins in meta-analysesstatistical analyses that combine the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods studies⁶³Xie W, Ning L et al. Statin use and survival outcomes in endocrine-related gynecologic cancers: a systematic review and meta-analysis. Oncotarget. 2017;8:41508–41517.

Cervical cancer: modest evidence of better overall and progression-free survival after radical hysterectomy and/or para-aortic lymph node dissection among people with stage 1B to 4 cervical cancer treated with statins

Better overall and progression-free survival after radical hysterectomy and/or para-aortic lymph node dissection among people with stage 1B to 4 cervical cancer treated with statins continuously since before a cancer diagnosis compared to no statins in an observational study⁶⁴Song MK, Shin BS, Ha CS, Park WY. Would lipophilic statin therapy as a prognostic factor improve survival in patients with uterine cervical cancer? International Journal of Gynecological Cancer. 2017 Sep;27(7):1431-1437.

Endometrial cancer: modest evidence of moderately better cancer-specific and progression-free survival among people with endometrial cancer treated with statins

25% lower mortality among women with endometrial cancer newly treated with statins after a cancer diagnosis compared to no statins, and stronger effects from hydrophilic statins compared to lipophilic statins, in a very large observational study⁶⁵Feng JL, Dixon-Suen SC, Jordan SJ, Webb PM. Is there sufficient evidence to recommend women diagnosed with endometrial cancer take a statin: results from an Australian record-linkage study. Gynecologic Oncology. 2021 Jun;161(3):858-863.
31% lower cancer-specific mortality among people with endometrial cancer treated with statins compared to no statins in 6 retrospective studies but no evidence of an effect in 1 prospective study in a very large meta-analysis of 7 observational studies⁶⁶Li J, Liu R et al. The association between statin use and endometrial cancer survival outcome: a meta-analysis. Medicine (Baltimore). 2018 Nov;97(47):e13264.
No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on 5-year cancer-specific survival among people with endometrial cancer treated with statins before diagnosis compared to no statins in a large observational study⁶⁷Segev Y, Gemer O et al. An Israeli gynecologic oncology group study of statin use and endometrial cancer prognosis. International Journal of Gynaecology & Obstetrics. 2020 Jan;148(1):79-86.

Kidney cancer

People with kidney cancer treated with statins have shown moderately better survival in some studies.

29% lower overall mortality but no evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on cancer-specific mortality or progression-free survivalthe time during and after treatment of a disease that a patient lives without disease progression (worsening) among people with kidney cancer (renal cell carcinoma) treated with statins compared to no statins in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 7 observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods studies⁶⁸Adli G, Yogiswara N, Gde Tirta Yoga Yatindra IB, Putra RM, Djatisoesanto W. Impact of statin on renal cell carcinoma patients undergoing nephrectomy. Does it affect cancer progression and improves survival? A systematic review and meta-analysis. Archivio Italiano de Urologia, Andrologia. 2023 Oct 4;95(3):11672.
33% lower cancer-specific mortality but no evidence of an effect on progression-free survival among people with kidney cancer treated with statins compared to no statins in a large meta-analysis of 12 observational studies⁶⁹Nayan M, Punjani N et al. Statin use and kidney cancer survival outcomes: a systematic review and meta-analysis. Cancer Treatment Reviews. 2017 Jan;52:105-116.
No evidence of an effect on cancer-specific mortality (2 studies) or progression-free survival (3 studies) among people with kidney cancer (renal cell carcinoma) treated with statins compared to no statins in meta-analyses of observational studies⁷⁰Luo Y, She DL, Xiong H, Fu SJ, Yang L. The prognostic effect of statin use on urologic cancers: an updated meta-analysis of 35 observational studies. Medicine (Baltimore). 2015 Sep;94(36):e1523.

Lung cancer

People with lung cancer treated with statins have shown slightly lower cancer-specific mortality in some situations, although not always after treatment with immune checkpoint inhibitors, and not after curative resection or chemoradiation.

17% lower cancer-specific mortality among people with lung cancer treated with statins compared to no statins, with larger benefits among people with stage 4 cancer than mixed stages, in a large meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 13 observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods studies⁷¹Chen Y, Li X et al. Effects of statin exposure and lung cancer survival: a meta-analysis of observational studies. Pharmacological Research. 2019 Mar;141:357-365.
11% lower cancer-specific mortality (6 observational studies), with stronger effects from use of statins before diagnosis, but no evidence of an effect on progression-free survivalthe time during and after treatment of a disease that a patient lives without disease progression (worsening) (1 RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects and 5 observational studies) among people with lung cancer treated with statins compared to no statins in meta-analyses⁷²Xia DK, Hu ZG, Tian YF, Zeng FJ. Statin use and prognosis of lung cancer: a systematic review and meta-analysis of observational studies and randomized controlled trials. Drug Design, Development and Theory. 2019 Jan 23;13:405-422.
11% lower overall mortality among people with squamous-cell carcinoma patients and 13% lower overall mortality among people with adenocarcinoma, with stronger benefits among people treated with statins after a cancer diagnosis, but no evidence of an effect on mortality among people with small-cell lung cancer treated with statins compared to no statins in a very large observational study⁷³Ung MH, MacKenzie TA, Onega TL, Amos CI, Cheng C. Statins associate with improved mortality among patients with certain histological subtypes of lung cancer. Lung Cancer. 2018 Dec;126:89-96.

After treatment with immune checkpoint inhibitors: insufficient (mixed) evidencepreclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example) (this is the CancerChoices definition; other researchers and studies may define this differently) of an effect on survival after treatment with immune checkpoint inhibitors among people with non-small cell lung cancer treated with statins

Better therapeutic response and 46% lower overall mortality after anti–PD-1 immunotherapy (4 studies) and 21% lower mortality after other treatments (15 studies) among people with non-small cell lung cancer treated with statins compared to no statins in meta-analyses of observational studies⁷⁴Mao W, Cai Y et al. Statin shapes inflamed tumor microenvironment and enhances immune checkpoint blockade in non-small cell lung cancer. JCI Insight. 2022 Sep 22;7(18):e161940.
No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on progression-free survival but a weak trendan apparent change due to a therapy, close to but not achieving full statistical significance (this is the CancerChoices definition; other researchers and studies may define this differently toward lower overall mortality after treatment with immune checkpoint inhibitors among people with non-small cell lung cancer treated with statins compared to no statins in a meta-analysis of 8 observational studies⁷⁵Zhang L, Wang H, Tian J, Sui L, Chen X. Concomitant statins and the survival of patients with non-small-cell lung cancer treated with immune checkpoint inhibitors: a meta-analysis. International Journal of Clinical Practice. 2022 Jul 5;2022:3429462.

After surgery: no evidence of an effect on overall survival after curative resection among people with non-small cell lung cancer treated with statins in one study

No evidence of an effect on overall survival after curative resection among people with non-small cell lung cancer treated with statins at least 1 month before surgery and continuing after the surgery compared to no statins in a mid-sized observational study⁷⁶Oh TK, Kim K et al. Impact of statin use on recurrence or survival after surgical curative resection of non-small cell lung cancer. Cancer Control. 2018 Jan-Mar;25(1):1073274818778000.

After chemoradiation: weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) of better loco-regional control but no evidence of an effect on survival after definitive chemoradiation among people with non-small cell lung cancer treated with statins

A weak trend toward better 2-year loco-regional control but no evidence of an effect on survival after definitive chemoradiation with curative intent among people with stage 3 non-small cell lung cancer treated with statins compared to no statins in a mid-sized observational study⁷⁷Iarrobino NA, Gill BS et al. The impact of serum glucose, anti-diabetic agents, and statin usage in non-small cell lung cancer patients treated with definitive chemoradiation. Frontiers in Oncology. 2018 Jul 27;8:281.

Mutant p53 lung cancer: weak evidence of better survival after lung resection among people with mutant p53 lung cancer treated with statins

Apparently better survival after lung resection among people with mutant p53 lung cancer (lung adenocarcinoma) treated with statins compared to no statins in a mid-sized observational study;⁷⁸Nishikawa S, Menju T et al. Statins may have double-edged effects in patients with lung adenocarcinoma after lung resection. Cancer Management and Research. 2019 Apr 18;11:3419-3432. also see evidence from this study that people with wild-type p53 had worse survival when treated with statins in Safety and precautions ›

Lymphoma

Only people with Burkitt lymphoma have shown a survival benefit from using statins, and it was substantial. No other types of lymphoma have shown any survival benefit from statins.

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on progression-free survivalthe time during and after treatment of a disease that a patient lives without disease progression (worsening) or overall mortality among people with diffuse large B cell lymphoma treated with statins in a combined analysis of studies

No evidence of an effect on progression-free survival or overall mortality, although people from Western countries did show benefit on overall survival, among people with diffuse large B cell lymphoma treated with statins compared to no statins in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 8 observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods studies⁷⁹Li Y, Zhou H, Zou L. Influence of statins on the survival outcomes of patients with diffuse large B cell lymphoma: a systematic review and meta-analysis. International Journal of Clinical Practice. 2022 Jul 30;2022:5618290.

No evidence of an effect on overall survival or event-free survival among people with non-Hodgkin lymphoma treated with statins in a combined analysis of studies

No evidence of an effect on overall survival or event-free survival among people with non-Hodgkin lymphoma treated with statins compared to no statins in a meta-analysis of 9 observational studies⁸⁰Ye X, Mneina A, Johnston JB, Mahmud SM. Associations between statin use and non-Hodgkin lymphoma (NHL) risk and survival: a meta-analysis. Hematological Oncology. 2017 Jun;35(2):206-214.

91% lower cancer-specific mortality among people with Burkitt lymphoma but no evidence of an effect on survival among people with other non-Hodgkin lymphomas treated with statins within 6 months before diagnosis of diagnosis compared to no statins in a very large observational study⁸¹Brånvall E, Eloranta S, Ekberg S, Birmann BM, Smedby KE. Statin use and prognosis in 12,865 non-Hodgkin lymphoma patients treated in the rituximab-era. Hematological Oncology. 2017 Jun;35(2suppl):230–232.

Melanoma

People with melanoma treated with statins have shown slightly better survival and a moderately lower marker of advanced cancer.

3% lower cancer-specific mortality among females with melanoma with each additional 10% adherence to 1-year of lipid-lowering medications in a large observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods study⁸²Feng JL, Qin X. Does adherence to lipid-lowering medications improve cancer survival? A nationwide study of breast and colorectal cancer, and melanoma. British Journal of Clinical Pharmacology. 2021 Apr;87(4):1847-1858.

A weak trendan apparent change due to a therapy, close to but not achieving full statistical significance (this is the CancerChoices definition; other researchers and studies may define this differently toward higher relative survival for 3 years after a melanoma diagnosis among men but no evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. among women treated with statins compared to no statins in a mid-sized observational study⁸³Livingstone E, Hollestein LM et al. Statin use and its effect on all-cause mortality of melanoma patients: a population-based Dutch cohort study. Cancer Medicine. 2014 Oct;3(5):1284-93.

19% lower Breslow thickness—a measure of the advancement of skin cancer—among people with cutaneous melanoma treated with statins compared to no statins in a mid-sized observational study⁸⁴Koomen ER, Joosse A et al. Is statin use associated with a reduced incidence, a reduced Breslow thickness or delayed metastasis of melanoma of the skin? European Journal of Cancer. 2007 Nov;43(17):2580-9.

Myeloma

People with myeloma treated with statins have shown better survival. Treatment with simvastatin may lower resistance to some chemotherapy drugs for people with myeloma.

24% lower cancer-specific mortality among people with myeloma treated with statins at the time of cancer diagnosis or afterward compared to no statins in a large observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods study⁸⁵Sanfilippo KM, Keller J et al. Statins are associated with reduced mortality in multiple myeloma. Journal of Clinical Oncology. 2016 Nov 20;34(33):4008-4014.
Longer progression-free survivalthe time during and after treatment of a disease that a patient lives without disease progression (worsening) and a shorter response time after treatment with thalidomide and dexamethasone among people with relapsed or refractory myeloma treated with lovastatin compared to no lovastatin in a small RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects⁸⁶Hus M, Grzasko N et al. Thalidomide, dexamethasone and lovastatin with autologous stem cell transplantation as a salvage immunomodulatory therapy in patients with relapsed and refractory multiple myeloma. Annals of Hematology. 2011 Oct;90(10):1161-6.
No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on tumor response (free monoclonal light chains or monoclonal proteins in serum) among heavily pretreated people with myeloma treated with 15 mg/kg simvastatin per day for 7 days followed by a rest period of 21 days in two 4-week cycles compared to baseline in a small uncontrolled triala study in which a therapy is used, but without a comparison group against which to judge outcomes; an uncontrolled trial is considered a weak study design⁸⁷Sondergaard TE, Pedersen PT et al. A phase II clinical trial does not show that high dose simvastatin has beneficial effect on markers of bone turnover in multiple myeloma. Hematological Oncology. 2009 Mar;27(1):17-22.

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of lower resistance to some chemotherapy drugs among people with refractory or relapsed myeloma treated with simvastatin

Reduced resistance to bortezomib and bendamustine among people with myeloma refractory to 2 cycles of bortezomib or bendamustine treated with simvastatin during 2 further cycles compared to no simvastatin in a small controlled triala study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial⁸⁸Schmidmaier R, Baumann P et al. First clinical experience with simvastatin to overcome drug resistance in refractory multiple myeloma. European Journal of Haematology. 2007 Sep;79(3):240-3.
No evidence of an effect on resistance to vincristine, adriamycin and dexamethasone among people with refractory or relapsed myeloma treated with high-dose simvastatin compared to baseline in a small uncontrolled trial⁸⁹van der Spek E, Bloem AC, Sinnige HA, Lokhorst H. High dose simvastatin does not reverse resistance to vincristine, adriamycin, and dexamethasone (VAD) in myeloma. Haematologica. 2007 Dec;92(12):e130-1.

Ovarian cancer

People with ovarian cancer treated with statins show moderately better survival.

16% lower cancer-specific mortality (7 studies) but no evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on progression-free mortality (2 studies) among people with ovarian cancer treated with statins (either lipophilic or hydrophilic) compared to no statins, with stronger benefits among people treated with statins after a cancer diagnosis, in meta-analysesstatistical analyses that combine the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods studies⁹⁰Wang Q, Zhi Z et al. Statin use improves the prognosis of ovarian cancer: an updated and comprehensive meta-analysis. Oncology Letters. 2022 Dec 23;25(2):65.
24% lower overall mortality among people with ovarian cancer treated with statins compared to no statins in a meta-analysis of 9 observational studies⁹¹Mohammadian-Hafshejani A, Sherwin CMT, Heidari-Soureshjani S. Do statins play any role in reducing the incidence and mortality of ovarian cancer? A systematic review and meta-analysis. Journal of Preventive Medicine and Hygiene. 2020 Oct 6;61(3):E331-E339.
Lower cancer-specific mortality—57% lower for high-grade serous carcinoma, 35% lower for endometroid cancer, 40% lower for mucinous cancer, and 70% lower for borderline—among people with ovarian cancer treated lipophilic statins, especially atorvastatin or simvastatin, after a cancer diagnosis, but no evidence of an effect from other statins in a very large observational study;⁹²Visvanathan K, Modur S, Artama M, Murtola T. Lipophilic statins show promise for treatment of epithelial ovarian cancer. Cancer Research. 2020 Aug;80(16suppl):5782-5782. also see evidence of a weak trendan apparent change due to a therapy, close to but not achieving full statistical significance (this is the CancerChoices definition; other researchers and studies may define this differently toward higher mortality among people with clear cell cancer treated with statins in Safety and precautions ›
24% lower overall mortality among people with ovarian cancer treated with statins compared to no statins in a meta-analysis of observational studies judged to be free of immortal time bias⁹³Majidi A, Na R, Dixon-Suen S, Jordan SJ, Webb PM. Common medications and survival in women with ovarian cancer: a systematic review and meta-analysis. Gynecological Oncology. 2020 Jun;157(3):678-685.
13% lower cancer-specific mortality among people with ovarian cancer treated with statins after a cancer diagnosis, and increased benefit with increased intensity of use, in a large meta-analysis of 3 observational studies⁹⁴Li X, Zhou J. Impact of postdiagnostic statin use on ovarian cancer mortality: a systematic review and meta-analysis of observational studies. British Journal of Clinical Pharmacology. 2018 Jun;84(6):1109-1120.

Pancreatic cancer

People with pancreatic cancer treated with statins show slightly to moderately better survival.

Also see information regarding advanced pancreatic cancer above in Advanced cancer.

14% lower overall mortality among people with pancreatic cancer treated with statins compared to no statins in a large meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 13 observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods studies with evidence of publication bias, but no evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. in a meta-analysis of 2 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects⁹⁵Anbari K, Amiri MM, Heidari-Soureshjani S, Sherwin CM, Kasiri K. A systematic review and meta-analysis on the role of statins in the prevention of mortality following pancreatic cancer. Anticancer Agents in Medicinal Chemistry. 2023;23(19):2073-2082.
13% lower overall mortality after surgical resection among people with pancreatic ductal adenocarcinoma treated with statins (especially rosuvastatin) compared to no statins, but only a weak trendan apparent change due to a therapy, close to but not achieving full statistical significance (this is the CancerChoices definition; other researchers and studies may define this differently for lower mortality in a large meta-analysis of 14 observational studies and RCTs⁹⁶Tamburrino D, Crippa S et al. Statin use improves survival in patients with pancreatic ductal adenocarcinoma: a meta-analysis. Digestive and Liver Disease. 2020 Apr;52(4):392-399.
23% lower overall mortality among people with pancreatic adenocarcinoma treated with statins compared to no statins in a meta-analysis of 5 observational studies⁹⁷Wang D, Rodriguez EA, Barkin JS, Donath EM, Pakravan AS. Statin use shows increased overall survival in patients diagnosed with pancreatic cancer: a meta-analysis. Pancreas. 2019 Apr;48(4):e22-e23.
25% lower overall mortality among people with pancreatic cancer treated with statins compared to no statins in a large meta-analysis of 6 observational studies⁹⁸Jian-Yu E, Graber JM et al. Effect of metformin and statin use on survival in pancreatic cancer patients: a systematic literature review and meta-analysis. Current Medicinal Chemistry. 2018;25(22):2595-2607.

Prostate cancer

People with prostate cancer treated with statins show moderately lower cancer-specific mortality, with stronger effects with use before a cancer diagnosis. Statin use combined with radical prostatectomy does not appear to provide any benefit.

Also see information regarding advanced prostate cancer above in Advanced cancer.

Statins at unspecified times: good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) of moderately lower cancer-specific mortality among people with prostate cancer treated with statins

43% lower overall mortality among people with prostate cancer treated with hydrophilic statins and 35% lower mortality among people using lipophilic statins compared to no statins in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 7 observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods studies⁹⁹Cao Z, Yao J et al. Association between statin exposure and incidence and prognosis of prostate cancer: a meta-analysis based on observational studies. American Journal of Clinical Oncology. 2023 Jul 1;46(7):323-334.
28% lower cancer-specific mortality among people with prostate cancer treated with statins compared to no statins in a meta-analysis of 8 observational studies¹⁰⁰Yang J, Li C et al. Impact of statin use on cancer-specific mortality and recurrence: a meta-analysis of 60 observational studies. Medicine (Baltimore). 2020 Apr;99(14):e19596.
24% lower cancer-specific mortality (5 studies) and 22% lower risk of metastases (6 studies) among people with prostate cancer treated with statins compared to no statins in meta-analyses of observational studies¹⁰¹Raval AD, Thakker D et al. Association between statins and clinical outcomes among men with prostate cancer: a systematic review and meta-analysis. Prostate Cancer and Prostatic Diseases. 2016 Jun;19(2):151-62.
30% lower cancer-specific mortality (7 studies) but no evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on progression-free survivalthe time during and after treatment of a disease that a patient lives without disease progression (worsening) (5 studies) among people with prostate cancer treated with statins compared to no statins in meta-analyses of observational studies¹⁰²Luo Y, She DL, Xiong H, Fu SJ, Yang L. The prognostic effect of statin use on urologic cancers: an updated meta-analysis of 35 observational studies. Medicine (Baltimore). 2015 Sep;94(36):e1523.

Statin use at specified times

Good evidence of moderately lower cancer-specific mortality among people with prostate cancer treated with statins after a cancer diagnosis and greater benefits when treated with statins before diagnosis

36% lower cancer-specific mortality among people with prostate cancer treated with statins after a cancer diagnosis (4 studies) and 47% lower cancer-specific mortality with use before diagnosis (6 studies) compared to no statins in meta-analyses of observational studies¹⁰³Meng Y, Liao YB, Xu P, Wei WR, Wang J. Statin use and mortality of patients with prostate cancer: a meta-analysis. OncoTargets and Therapy. 2016 Mar 21;9:1689-96.
23% lower cancer-specific mortality among people with prostate cancer treated with statins after diagnosis (3 studies) and 56% lower mortality among people using statins before diagnosis (3 studies) in meta-analyses of observational studies¹⁰⁴Zhong S, Zhang X et al. Statin use and mortality in cancer patients: systematic review and meta-analysis of observational studies. Cancer Treatment Reviews. 2015 Jun;41(6):554-67.

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on markers of tumor proliferation among men with prostate cancer treated with atorvastatin every day before radical prostatectomy

No evidence of an effect on tumor proliferation index Ki-67 or serum prostate-specific antigen (PSA) among men with prostate cancer treated with atorvastatin every day before radical prostatectomy (median of 27 days) compared to placeboa pill, medicine, or procedure—thought to be both harmless and ineffective—prescribed for the psychological benefit to the patient or as a sham treatment in a study to allow a comparison to a therapy of interest in a mid-sized RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects¹⁰⁵Murtola TJ, Syvälä H et al. Atorvastatin versus placebo for prostate cancer before radical prostatectomy—a randomized, double-blind, placebo-controlled clinical trial. European Urology. 2018 Dec;74(6):697-701.

Statins combined with other therapies

Pravastatin, cytarabine, and idarubicin used together have shown minimal effects on remission.

Optimizing your body terrain

Do statins promote an environment within your body that is less supportive of cancer development, growth, or spread? We present the evidence.

See Optimizing Your Body Terrain ›

Find medical professionals who specialize in managing body terrain factors: Finding Integrative Oncologists and Other Practitioners ›

Bleeding and coagulation imbalance

People treated with lipophilic statins showed lower markers of activated coagulation in many studies.

Lipophilic statins: modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of at least one lower marker of activated coagulation among people treated with statins (mostly lipophilic) for 12 weeks or longer

A lower marker of activated coagulation (plasma D-dimer levels) among people treated with statins for 12 weeks or longer compared to no statins, mostly when using lipophilic statins, in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 9 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects¹⁰⁸Sahebkar A, Serban C et al; Lipid and Blood Pressure Meta-analysis Collaboration (LBPMC) Group. Association between statin use and plasma D-dimer levels. A systematic review and meta-analysis of randomised controlled trials. Thrombosis and Haemostasis. 2015 Aug 31;114(3):546-57.
No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on platelet activity among women with metabolic syndromea cluster of conditions that occur together, including increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels treated with 80 mg atorvastatin for 12 weeks compared to placeboa pill, medicine, or procedure—thought to be both harmless and ineffective—prescribed for the psychological benefit to the patient or as a sham treatment in a study to allow a comparison to a therapy of interest in a small RCT¹⁰⁹Velarde GP, Choudhary N et al. Effect of atorvastatin on lipogenic, inflammatory and thrombogenic markers in women with the metabolic syndrome. Nutrition, Metabolism, and Cardiovascular Diseases. 2021 Feb 8;31(2):634-640.
No evidence of an effect on a coagulation factor (fibrinolytic pathway) in the first 24 hours after colorectal surgery among people treated with 40 mg oral simvastatin once a day for 3 to 7 days before surgery compared to placebo in a small RCT¹¹⁰Alexander ZE, Su’a B et al. The effect of oral simvastatin on fibrinolytic activity after colorectal surgery-a pilot study. Journal of Surgical Research. 2016 Sep;205(1):28-32.

Hydrophilic statins:

Higher markers of both coagulation and anticoagulation in plasma extracellular vesicles (plasminogen and von Willebrand factor) in the LDL plasma fraction, an increase an anticoagulant protein SerpinC1) in serum, but less increase in serum plasminogen levels, and no evidence of an effect on serum VWF levels among people with subclinical atherosclerosis treated with rosuvastatin in a large RCT¹¹¹Verbree-Willemsen L, Zhang YN et al; METEOR Study Group. LDL extracellular vesicle coagulation protein levels change after initiation of statin therapy. Findings from the METEOR trial. International Journal of Cardiology. 2018 Nov 15;271:247-253.
10% reduction in a marker of lower potential to form blood clots (endogenous thrombin potential) among people with prior venous thromboembolism treated with 20 mg per rosuvastatin day for 4 weeks after anticoagulation withdrawal compared to no rosuvastatin in a mid-sized RCT¹¹²Orsi FA, Biedermann JS et al. Rosuvastatin use reduces thrombin generation potential in patients with venous thromboembolism: a randomized controlled trial. Journal of Thrombosis and Haemostasis. 2019 Feb;17(2):319-328.
Larger reductions in markers of risk of recurrent clot formation (FVIII:C, von Willebrand factor:Ag, FVII:C, FXI:C, and D-dimer) among people with prior venous thrombosis treated with 20 mg rosuvastatin per day for 4 weeks compared to no rosuvastatin in a mid-sized RCT¹¹³Biedermann JS, Kruip MJHA et al. Rosuvastatin use improves measures of coagulation in patients with venous thrombosis. European Heart Journal. 2018 May 14;39(19):1740-1747.

Body weight

Atorvastatin has not shown any effect on body mass index or waist circumference among women with metabolic disorders in many studies.

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on body mass index or waist circumference among women with metabolic disorders treated with atorvastatin in a combined analysis of studies

No evidence of an effect on body mass index among people with polycystic ovary syndrome treated with atorvastatin compared to placeboa pill, medicine, or procedure—thought to be both harmless and ineffective—prescribed for the psychological benefit to the patient or as a sham treatment in a study to allow a comparison to a therapy of interest in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 9 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects¹¹⁴Chen LL, Zheng JH. Effects of atorvastatin on the insulin resistance in women of polycystic ovary syndrome: a systematic review and meta-analysis. Medicine (Baltimore). 2021 Jun 18;100(24):e26289.
No evidence of an effect on waist circumference among women with metabolic syndromea cluster of conditions that occur together, including increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels treated with 80 mg atorvastatin for 12 weeks compared to placebo in a small RCT¹¹⁵Velarde GP, Choudhary N et al. Effect of atorvastatin on lipogenic, inflammatory and thrombogenic markers in women with the metabolic syndrome. Nutrition, Metabolism, and Cardiovascular Diseases. 2021 Feb 8;31(2):634-640.

High blood sugar and insulin resistance

People with metabolic disorders (not cancer) treated with statins show lower markers of high blood sugar and insulin resistancea condition in which cells in your muscles, fat, and liver don’t respond well to insulin and can’t efficiently take up glucose from your blood for energy in some studies, but other studies show higher markers of diabetes among people using statins.

Lower fasting glucose (11 studies) and insulin sensitivity index (7 studies) but no evidence of an effect on fasting insulin (10 studies) or quantitative insulin sensitivity check index (3 studies) among people with polycystic ovary syndrome treated with statins compared to no statins in meta-analysesstatistical analyses that combine the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects¹¹⁶Miao K, Zhou H. Effect of statins combined or not combined with metformin on polycystic ovary syndrome: a systematic review and meta-analysis. Journal of Obstetrics and Gynaecology Research. 2022 Jul;48(7):1806-1815.
Lower fasting insulin levels and homeostasis model assessment of insulin resistance (HOMA-IR) but no evidence of an effect on fasting glucose among people with polycystic ovary syndrome treated with atorvastatin compared to placeboa pill, medicine, or procedure—thought to be both harmless and ineffective—prescribed for the psychological benefit to the patient or as a sham treatment in a study to allow a comparison to a therapy of interest in a meta-analysis of 9 RCTs¹¹⁷Chen LL, Zheng JH. Effects of atorvastatin on the insulin resistance in women of polycystic ovary syndrome: a systematic review and meta-analysis. Medicine (Baltimore). 2021 Jun 18;100(24):e26289.
No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on fasting blood glucose among women with metabolic syndromea cluster of conditions that occur together, including increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels treated with 80 mg atorvastatin for 12 weeks compared to placebo in a small RCT¹¹⁸Velarde GP, Choudhary N et al. Effect of atorvastatin on lipogenic, inflammatory and thrombogenic markers in women with the metabolic syndrome. Nutrition, Metabolism, and Cardiovascular Diseases. 2021 Feb 8;31(2):634-640.

Also see evidence of risk for higher markers of diabetes among people using statins in Safety and precautions ›

Hormone imbalance

Changes in hormone levels seen in the studies here may not be beneficial in every situation. Your oncology team needs to determine whether any changes would be favorable for your condition.

People treated with statins did not show lower levels of a stress hormone in one study. Statins increase levels of the metabolic hormone adiponectina hormone and signaling protein involved in regulating glucose levels and fatty acid breakdown but do not seem to affect leptina hormone that helps regulate energy balance by inhibiting hunger or resistina hormone that affects insulin action, glucose and lipid homeostasis, and energy. People treated with statins show many changes in levels of sex hormones, although people with prostate cancer treated with atorvastatin either before or after radical prostatectomy did not see an effect on testosterone and most other sex hormone levels. Statin use may lower aldosterone levels among people with high blood pressure or diabetes.

Stress hormones

Also see evidence of higher markers of stress among people using statins in Safety and precautions ›

No evidence of an increase in cortisol levels after angiotensin-II stimulation (which increases blood pressure and cortisol secretion) among people with high blood pressure (hypertension) treated with statins in one large study

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on cortisol levels after angiotensin-II stimulation among people with high blood pressure (hypertension) treated with statins compared to no statins in a large observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods study¹¹⁹Baudrand R, Pojoga LH et al. Statin use and adrenal aldosterone production in hypertensive and diabetic subjects. Circulation. 2015 Nov 10;132(19):1825-33.

Metabolism hormones

No evidence of an effect on serum leptin levels among people treated with statins in combined analyses of studies

No evidence of an effect on serum leptin levels among women with metabolic syndrome treated with 80 mg atorvastatin for 12 weeks compared to placeboa pill, medicine, or procedure—thought to be both harmless and ineffective—prescribed for the psychological benefit to the patient or as a sham treatment in a study to allow a comparison to a therapy of interest in a small RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects¹²⁰Velarde GP, Choudhary N et al. Effect of atorvastatin on lipogenic, inflammatory and thrombogenic markers in women with the metabolic syndrome. Nutrition, Metabolism, and Cardiovascular Diseases. 2021 Feb 8;31(2):634-640.
No evidence of an effect on serum leptin levels among people treated with statins compared to placebo in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 6 controlled trialsa study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial¹²¹Sahebkar A, Giua R, Pedone C. Impact of statin therapy on plasma leptin concentrations: a systematic review and meta-analysis of randomized placebo-controlled trials. British Journal of Clinical Pharmacology. 2016 Dec;82(6):1674-1684.

Higher plasma adiponectin levels among people treated with statins, especially for 12 weeks or longer, compared to placebo in a meta-analysis of 30 RCTs¹²²Chruściel P, Sahebkar A et al; Lipid and Blood Pressure Meta-analysis Collaboration (LBPMC) Group. Impact of statin therapy on plasma adiponectin concentrations: a systematic review and meta-analysis of 43 randomized controlled trial arms. Atherosclerosis. 2016 Oct;253:194-208.

No evidence of an effect on plasma resistin levels, although a slight reduction in visfatin levels among people treated with statins in a combined analysis of studies

No evidence of an effect on plasma resistin levels, although a slight reduction in visfatin levels among people treated with statins compared to controls in a meta-analysis of 14 controlled trials¹²³Sahebkar A, Giorgini P et al. Impact of statin therapy on plasma resistin and visfatin concentrations: a systematic review and meta-analysis of controlled clinical trials. Pharmacological Research. 2016 Sep;111:827-837.

Sex hormones

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of lower adrenal androgen in the serum and possibly in the prostate but no evidence of an increase in testosterone and sex hormone binding globulin levels among people with prostate cancer treated with atorvastatin either before or after radical prostatectomy in two studies

Lower adrenal androgen in the serum and possibly in the prostate but no evidence of an effect on most serum and prostatic steroids, including testosterone and dihydrotestosterone, among men with localized prostate cancer treated with 80 mg atorvastatin before radical prostatectomy for a median of 28 days compared to placebo in a mid-sized RCT¹²⁴Raittinen PVH, Syvälä H et al. Atorvastatin induces adrenal androgen downshift in men with prostate cancer: a post hoc analysis of a pilot adaptive randomised clinical trial. EBioMedicine. 2021 Jun;68:103432.
No evidence of an increase in testosterone and sex hormone binding globulin levels after radical prostatectomy among people with pathologic high-risk prostate cancer treated with 20 mg atorvastatin per day for 1 year compared to placebo in a mid-sized RCT¹²⁵Jeong IG, Lim B et al. Adjuvant low-dose statin use after radical prostatectomy: the PRO-STAT randomized clinical trial. Clinical Cancer Research. 2021 Sep 15;27(18):5004-5011.

Strong evidenceconsistent, significant effects in several large (or at least one very large) well designed clinical studies or at least two meta-analyses of clinical studies of moderate or better quality (or one large meta-analysis) finding similar results (this is the CancerChoices definition; other researchers and studies may define this differently) of changes in sex hormone levels among people, including those with polycystic ovary syndrome or high cholesterol, treated with statins

Changes in sex hormone levels among men with high cholesterol (hypercholesterolemia) treated with statins (not specific to cancer) compared to baseline in several meta-analyses:¹²⁶Glina FPA, Lopes L et al. Do statins decrease testosterone in men? Systematic review and meta-analysis. International Brazilian Journal of Urology. 2024 Mar-Apr;50(2):119-135.
- Lower total testosterone in separate meta-analyses of 11 RCTs and 12 observational studies
- Higher free testosterone levels in 5 cross-sectional studies but no evidence of an effect in 3 prospective studies
- Lower follicle-stimulating hormone levels in 8 observational studies but no evidence of an effect in 3 RCTs
- Lower luteinizing hormone levels in 2 cross-sectional studies but no evidence of an effect in 8 prospective observational studies or 3 RCTs
- Higher estradiol levels in 3 RCTs but a weak trendan apparent change due to a therapy, close to but not achieving full statistical significance (this is the CancerChoices definition; other researchers and studies may define this differently toward lower levels in 3 prospective observational studies and no evidence of an effect in 3 cross-sectional studies
- No evidence of an effect on sex hormone binding globulin in separate meta-analyses of 3 cross-sectional studies or 7 observational studies
Lower levels of total testosterone (11 studies), free testosterone (5 studies), dehydroepiandrosterone sulphate (11 studies), androstenedione (4 studies), luteinizing hormone (LH, 8 studies), LH to follicle-stimulating hormone (FSH) ratio (5 studies), and prolactin (5 studies), and a weak trend toward lower FSH among people with polycystic ovary syndrome treated with statins compared to no statins in meta-analyses of RCTs¹²⁷Miao K, Zhou H. Effect of statins combined or not combined with metformin on polycystic ovary syndrome: a systematic review and meta-analysis. Journal of Obstetrics and Gynaecology Research. 2022 Jul;48(7):1806-1815.
Changes in hormone levels among people treated with atorvastatin for at least 3 weeks (not specific to cancer) compared with placebo or no treatment in meta-analyses¹²⁸Shawish MI, Bagheri B, Musini VM, Adams SP, Wright JM. Effect of atorvastatin on testosterone levels. Cochrane Database of Systematic Reviews. 2021 Jan 22;1(1):CD013211.
- No evidence of an effect on total testosterone levels among males in 2 RCTs
- Lower total testosterone, A4, and dehydroepiandrosterone sulphate (DHEAS) levels among females with polycystic ovary syndrome in 4 RCTs
- Lower free androgen index and higher sex hormone binding globulin levels among females with polycystic ovary syndrome in 2 RCTs
Lower plasma dehydroepiandrosterone (DHEA) levels among women with polycystic ovary syndrome treated with statins, with stronger effects from atorvastatin than simvastatin, compared to controls in a meta-analysis of 10 RCTs¹²⁹Yang S, Gu YY, Jing F, Yu CX, Guan QB. The effect of statins on levels of dehydroepiandrosterone (DHEA) in women with polycystic ovary syndrome: a systematic review and meta-analysis. Medicine Science Monitor. 2019 Jan 20;25:590-597.
Lower markers of hormone activity (estrogen-induced proliferation and proliferating cell nuclear antigen (PCNA) expression) among women with symptomatic fibroids (leiomyomas) treated with 40 mg simvastatin daily for 12 weeks before hysterectomy or myomectomy compared to placebo in a small RCT¹³⁰Afrin S, El Sabeh M et al. Simvastatin modulates estrogen signaling in uterine leiomyoma via regulating receptor palmitoylation, trafficking and degradation. Pharmacological Research. 2021 Oct;172:105856.

Preliminary evidence of higher symptom response to treatment with metformin for polycystic ovary syndrome among women also treated with simvastatin

Higher symptom control response to treatment with metformin among women with polycystic ovary syndrome also treated with simvastatin compared to no simvastatin in a mid-sized RCT¹³¹Malik M, Tasnim N, Mahmud G. Effect of metformin alone compared with metformin plus simvastatin on polycystic ovarian syndrome in Pakistani women. Journal of the College of Physicians and Surgeons—Pakistan. 2018 Mar;28(3):184-187.

Other hormones: modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of lower aldosterone levels among people with high blood pressure or diabetes treated with statins

33% lower aldosterone levels after angiotensin-II stimulation among people with high blood pressure (hypertensive) treated with statins compared to no statins in a large observational study¹³²Baudrand R, Pojoga LH et al. Statin use and adrenal aldosterone production in hypertensive and diabetic subjects. Circulation. 2015 Nov 10;132(19):1825-33.
26% lower aldosterone levels after angiotensin-II stimulation and a high-salt diet among diabetic people treated with statins, especially lipophilic statins, compared to no statins in a mid-sized observational study¹³³Baudrand R, Pojoga LH et al. Statin use and adrenal aldosterone production in hypertensive and diabetic subjects. Circulation. 2015 Nov 10;132(19):1825-33.

Inflammation

Substantial evidence shows people treated with statins have lower markers of inflammation, including people with conditions other than cancer, such as metabolic imbalances, heart failure, chronic kidney disease, or asthma.

Strong evidenceconsistent, significant effects in several large (or at least one very large) well designed clinical studies or at least two meta-analyses of clinical studies of moderate or better quality (or one large meta-analysis) finding similar results (this is the CancerChoices definition; other researchers and studies may define this differently) of a moderately lower marker of inflammation among people treated with statins

A 35% lower marker of inflammation (C-reactive protein) among people treated with statins compared to no statins in a large meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 16 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects¹³⁴Xie S, Galimberti F et al; META-LIPID Group. Effect of lipid-lowering therapies on C-reactive protein levels: a comprehensive meta-analysis of randomized controlled trials. Cardiovascular Research. 2024 Mar 30;120(4):333-344.
A slightly lower level of a marker of inflammation (hs-CRP) among people with polycystic ovary syndrome treated with statins compared to no statins in a meta-analysis of 7 RCTs¹³⁵Miao K, Zhou H. Effect of statins combined or not combined with metformin on polycystic ovary syndrome: a systematic review and meta-analysis. Journal of Obstetrics and Gynaecology Research. 2022 Jul;48(7):1806-1815.

Strong evidence of lower markers of inflammation among people with metabolic imbalances treated with statins

Lower markers of inflammation (C-reactive protein, 13 studies; serum IL-6, 4 studies) among adults with abnormal glucose homeostasis treated with atorvastatin compared to no atorvastatin in meta-analyses of RCTs¹³⁶Milajerdi A, Sadeghi A, Mousavi SM, Larijani B, Esmaillzadeh A. Influence of statins on circulating inflammatory cytokines in patients with abnormal glucose homeostasis: a meta-analysis of data from randomized controlled trials. Clinical Therapeutics. 2020 Feb;42(2):e13-e31.
A lower markers of inflammation (C-reactive protein) among adults with abnormal glucose homeostasis treated with simvastatin compared to no simvastatin in a meta-analysis of 6 RCTs¹³⁷Milajerdi A, Sadeghi A, Mousavi SM, Larijani B, Esmaillzadeh A. Influence of statins on circulating inflammatory cytokines in patients with abnormal glucose homeostasis: a meta-analysis of data from randomized controlled trials. Clinical Therapeutics. 2020 Feb;42(2):e13-e31.
Lower levels of markers of inflammation (CRP, 147 studies; TNF-α, 46 studies; IL-6, 68 studies; and IL-1, 15 studies) among people with metabolic syndromea cluster of conditions that occur together, including increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels or related disorders treated with statins compared to no statins in meta-analyses of RCTs¹³⁸Tabrizi R, Tamtaji OR et al. The effects of statin use on inflammatory markers among patients with metabolic syndrome and related disorders: a systematic review and meta-analysis of randomized controlled trials. Pharmacological Research. 2019 Mar;141:85-103.

Strong evidence of better markers of inflammation among people with heart failure treated with lipophilic statins

Better markers of inflammation (high sensitivity C-reactive protein, 7 studies; and IL-6, 6 studies) among people with heart failure treated with lipophilic statins compared to placebo or standard treatment in meta-analyses of RCTs¹³⁹Bonsu KO, Reidpath DD, Kadirvelu A. Effects of statin treatment on inflammation and cardiac function in heart failure: an adjusted indirect comparison meta-analysis of randomized trials. Cardiovascular Therapeutics. 2015 Dec;33(6):338-46.

Strong evidence of a lower marker of inflammation among people with chronic kidney disease treated with statins

A lower marker of inflammation (C-reactive protein) among people with chronic kidney disease treated with statins compared to no statins in a meta-analysis of 24 RCTs¹⁴⁰Wang J, Chen Z et al. Statins have an anti-inflammation in CKD patients: a meta-analysis of randomized trials. Biomedical Research International. 2022 Oct 22;2022:4842699.

Strong evidence of fewer asthma symptoms attributed to inflammation among people with asthma treated with statins

Fewer asthma symptoms attributed to inflammation among people with asthma treated with statins compared to no statins in a meta-analysis of 9 RCTs¹⁴¹Zhang QX, Zhang HF, Lu XT, Zhao J, Xu QX. Statins improve asthma symptoms by suppressing inflammation: a meta-analysis based on RCTs. European Review for Medical and Pharmacological Sciences. 2022 Nov;26(22):8401-8410.

Oxidative stress

Research on individual statins has found conflicting results regarding effects on oxidative stressan imbalance between free radicals and antioxidants in your body in which antioxidant levels are lower than normal; this imbalance can cause harmful oxidation reactions in your body chemistry.

Insufficient evidencepreclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example) (this is the CancerChoices definition; other researchers and studies may define this differently) of an effect on markers of oxidative stress among people treated with various individual statins across several studies

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on DNA oxidation or RNA oxidation among people treated with 40 mg simvastatin for 14 days compared to placeboa pill, medicine, or procedure—thought to be both harmless and ineffective—prescribed for the psychological benefit to the patient or as a sham treatment in a study to allow a comparison to a therapy of interest in a small RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects¹⁴²Rasmussen ST, Andersen JT et al. Simvastatin and oxidative stress in humans: a randomized, double-blinded, placebo-controlled clinical trial. Redox Biology. 2016 Oct;9:32-38.
Lower markers of oxidative stress (levels of angiopoietin-like protein 2 and glyceraldehyde-derived advanced glycation end-products) 2 weeks after percutaneous coronary intervention among people with heart attack (acute myocardial infarction) treated with an initial dose of 40 mg atorvastatin at admission followed by 10 mg per day for 30 days compared to no atorvastatin in an RCT¹⁴³Shimomura M, Oyama J et al. Acute effects of statin on reduction of angiopoietin-like 2 and glyceraldehyde-derived advanced glycation end-products levels in patients with acute myocardial infarction: a message from SAMIT (Statin for Acute Myocardial Infarction Trial). Heart and Vessels. 2016 Oct;31(10):1583-9.
A lower rate of biomarker increase in oxidative stress among children and young adults with autosomal dominant polycystic kidney disease treated with pravastatin (20 mg daily for people 8–12 years or 40 mg daily for people aged 13–22 years) compared to placebo in a small RCT¹⁴⁴Klawitter J, McFann K et al. Pravastatin therapy and biomarker changes in children and young adults with autosomal dominant polycystic kidney disease. Clinical Journal of the American Society of Nephrology. 2015 Sep 4;10(9):1534-41.
No evidence of an effect on a marker of oxidative stress (urinary 8-iso-prostaglandin F2α) among people with type 2 diabetes and dyslipidemia treated with either 10 or 80 mg atorvastatin per day for 30 weeks compared to placebo in a mid-sized RCT¹⁴⁵Tsikas D, Pham VV et al; DALI-Study Group. No effects of atorvastatin (10 mg/d or 80 mg/d) on nitric oxide, prostacyclin, thromboxane and oxidative stress in type 2 diabetes mellitus patients of the DALI study. Pharmacological Research. 2015 Apr;94:1-8.
A lower markers of oxidative stress (F2-isoprostane) among people with mixed dyslipidemia who had not achieved lipid targets on a standard statin dose treated with the highest dose of rosuvastatin (40 mg per day) compared to baseline in a small uncontrolled subset of an RCT¹⁴⁶Kei A, Tellis C, Liberopoulos E, Tselepis A, Elisaf M. Effect of switch to the highest dose of rosuvastatin versus add-on-statin fenofibrate versus add-on-statin nicotinic acid/laropiprant on oxidative stress markers in patients with mixed dyslipidemia. Cardiovascular Therapeutics. 2014 Aug;32(4):139-46.

Your microbiome

People with chest pain treated with rosuvastatin experienced some changes in their microbiomethe collection of microbes living on and within your body toward better function in one small study.

Managing side effects and promoting wellness

Are statins linked to fewer or less severe side effects or symptoms? Are they linked to less toxicity from cancer treatment? Do they support your quality of life or promote general well-being? We present the evidence.

Bone-related side effects

People with myeloma treated with statins have shown a moderately lower risk of a skeletal-related event.

Cardiovascular side effects

People with cancer at increased risk of chemotherapy-related cardiac dysfunction may show better cardiovascular function when treated with statins for longer than 4 weeks. People with thorax or head or neck cancer treated with statins after radiation therapy may show lower risk of stroke.

Preliminarysignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) but conflicting evidence of better cardiovascular function after chemotherapy, including anthracyclines, among people with cancer treated with statins for longer than 4 weeks

A better marker of cardiovascular function (less decline in left ventricular ejection fraction, LVEF) and less incidence of cancer therapy-related cardiac dysfunction during anthracycline-based chemotherapy among females with newly diagnosed breast cancer treated with 40 mg oral atorvastatin for 6 months compared to placeboa pill, medicine, or procedure—thought to be both harmless and ineffective—prescribed for the psychological benefit to the patient or as a sham treatment in a study to allow a comparison to a therapy of interest in a mid-sized RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects¹⁴⁹Mohamed AL, El-Abd AA, Mohamed HG, Noufal AM, Hennawy BS. Role of statin therapy in prevention of anthracycline-induced cardiotoxicity: a three dimentional echocardiography study. Current Problems in Cardiology. 2024 Jan;49(1 Pt C):102130.
No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on cardiovascular function (left ventricular ejection fraction, cardiovascular magnetic resonance edema and/or fibrosis, or peak high sensitivity troponin I) or incidence of cancer therapy-related cardiac dysfunction during anthracycline therapy among people with cancer at increased risk of anthracycline-related cardiac dysfunction treated with 40 mg atorvastatin once a day for 4 weeks compared to placebo in a mid-sized RCT¹⁵⁰Thavendiranathan P, Houbois C et al. Statins to prevent early cardiac dysfunction in cancer patients at increased cardiotoxicity risk receiving anthracyclines. European Heart Journal. Cardiovascular Pharmacotherapy. 2023 Sep 20;9(6):515-525.
55% lower 5‐year cumulative incidence of heart failure hospital presentations after treatment with anthracycline and a weak trend toward lower incidence after treatment with trastuzumab among women with breast cancer treated with statins compared to no statins in a large observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods study¹⁵¹Abdel-Qadir H, Bobrowski D et al. Statin exposure and risk of heart failure after anthracycline- or trastuzumab-based chemotherapy for early breast cancer: a propensity score‒matched cohort study. Journal of the American Heart Association. 2021 Jan 19;10(2):e018393.
No evidence of an effect on LVEF 6 months after starting treatment with doxorubicin (DOX) among people with breast cancer treated with statins compared to no statins in a mid-sized observational study, although the authors concluded that the sample size was too small to detect a difference¹⁵²Lang JK, Karthikeyan B et al. CBR3 V244M is associated with LVEF reduction in breast cancer patients treated with doxorubicin. Cardio-Oncology. 2021 May 11;7(1):17.
Less decline in left ventricular ejection fraction (LVEF) and lower incidence of chemotherapy-induced cardiomyopathy during chemotherapy among people with cancer treated with statins compared to no statins in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 7 observational studies¹⁵³Kim J, Nishimura Y, Kewcharoen J, Yess J. Statin use can attenuate the decline in left ventricular ejection fraction and the incidence of cardiomyopathy in cardiotoxic chemotherapy recipients: a systematic review and meta-analysis. Journal of Clinical Medicine. 2021 Aug 22;10(16):3731.
69% lower risk of adverse cardiac events during chemotherapy among people treated with statins compared to no statins in a meta-analysis of 12 RCTs and 2 observational studies¹⁵⁴Kalam K, Marwick TH. Role of cardioprotective therapy for prevention of cardiotoxicity with chemotherapy: a systematic review and meta-analysis. European Journal of Cancer. 2013 Sep;49(13):2900-9.

Modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of lower risk of stroke and a weak trendan apparent change due to a therapy, close to but not achieving full statistical significance (this is the CancerChoices definition; other researchers and studies may define this differently toward lower risk of cardiovascular or cerebrovascular events overall among people with thorax or head or neck cancer treated with statins after radiation therapy

32% lower risk of stroke and a weak trend toward lower risk of cardiovascular or cerebrovascular events overall among people with thorax or head or neck cancer treated with statins after radiation therapy in a large observational study¹⁵⁵Boulet J, Peña J et al. Statin use and risk of vascular events among cancer patients after radiotherapy to the thorax, head, and neck. Journal of the American Heart Association. 2019 Jul 2;8(13):e005996.

Surgical complications

Research regarding statins’ effects on surgery complications, including anastomotic leaks after colon resection, is conflicting.

Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) of fewer noninfectious complications but no evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on infectious complications after surgery for colorectal cancer among people treated with statins in two studies

A weak trendan apparent change due to a therapy, close to but not achieving full statistical significance (this is the CancerChoices definition; other researchers and studies may define this differently toward fewer noninfectious complications (cardiovascular events, stroke, renal failure, respiratory insufficiency, or thromboembolic events) but no evidence of an effect on infectious complications (sepsis, anastomotic leakage, or pneumonia) after surgery for colorectal cancer among people treated with statins compared to no statins in a very large observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods study¹⁵⁶Fransgaard T, Thygesen LC, Gögenur I. Statin use is not associated with improved 30-day survival in patients undergoing surgery for colorectal cancer. International Journal of Colorectal Disease. 2018 Feb;33(2):199-207.
No evidence of an effect on total complications or median hospital stay after elective colonic resection among people treated with statins compared to no statins in a mid-sized observational study¹⁵⁷Singh PP, Srinivasa S et al. Perioperative use of statins in elective colectomy. Diseases of the Colon & Rectum. 2012 Feb;55(2):205-10.

Insufficientpreclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example) (this is the CancerChoices definition; other researchers and studies may define this differently) and conflicting evidence of an effect on anastomotic leaks after colon resection among people treated with statins

Fewer anastomotic leaks after elective colonic resection among people treated with statins compared to no statins in a mid-sized observational study¹⁵⁸Singh PP, Srinivasa S et al. Perioperative use of statins in elective colectomy. Diseases of the Colon & Rectum. 2012 Feb;55(2):205-10.
No evidence of an effect on anastomotic leaks after colorectal resections with primary anastomosis among people treated with statins at the time of surgery compared to no statins in a large observational study with substantial limitations¹⁵⁹Bisgård AS, Noack MW, Klein M, Rosenberg J, Gögenur I. Perioperative statin therapy is not associated with reduced risk of anastomotic leakage after colorectal resection. Diseases of the Colon and Rectum. 2013 Aug;56(8):980-6.

Urinary side effects

Statins have not shown a meaningful effect on lower urinary tract symptoms among men with benign prostatic hyperplasia.

Side effects not specific to cancer

People with cardiovascular disease or conditions treated with statins show better measures of heart function and lower risk of a major cardiovascular event. However, people with type 2 diabetes and dyslipidemia have not seen any effect of statins on markers of cardiovascular function, nor women with metabolic syndrome on blood pressure.

People treated with statins show a slightly lower risk of all-cause dementia.

Short-term use of statins has not shown any effect on the rate of hospitalizations from small bowel obstructions or on in-hospital mortality after colorectal surgery or on 28-day hospital mortality among people with sepsis.

Cardiovascular side effects

Strong evidenceconsistent, significant effects in several large (or at least one very large) well designed clinical studies or at least two meta-analyses of clinical studies of moderate or better quality (or one large meta-analysis) finding similar results (this is the CancerChoices definition; other researchers and studies may define this differently) of better measures of heart function and lower risk of a major cardiovascular event among people with cardiovascular disease or conditions treated with statins

Better measures of heart function (left ventricular ejection fraction, 12 studies; and B-type natriuretic peptide, 7 studies) among people with heart failure treated with lipophilic statins compared to placeboa pill, medicine, or procedure—thought to be both harmless and ineffective—prescribed for the psychological benefit to the patient or as a sham treatment in a study to allow a comparison to a therapy of interest or standard treatment in meta-analysesstatistical analyses that combine the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects¹⁶¹Bonsu KO, Reidpath DD, Kadirvelu A. Effects of statin treatment on inflammation and cardiac function in heart failure: an adjusted indirect comparison meta-analysis of randomized trials. Cardiovascular Therapeutics. 2015 Dec;33(6):338-46.
Higher left ventricular ejection fraction 6 months after percutaneous coronary intervention among people with heart attack (acute myocardial infarction) treated with an initial dose of 40 mg atorvastatin at admission followed by 10 mg per day for 30 days compared to no atorvastatin in an RCT¹⁶²Shimomura M, Oyama J et al. Acute effects of statin on reduction of angiopoietin-like 2 and glyceraldehyde-derived advanced glycation end-products levels in patients with acute myocardial infarction: a message from SAMIT (Statin for Acute Myocardial Infarction Trial). Heart and Vessels. 2016 Oct;31(10):1583-9.
Lower risk of a first major cardiovascular event (death from coronary heart disease, nonfatal non-procedure-related myocardial infarction, resuscitated cardiac arrest, or fatal or nonfatal stroke) among people with coronary heart disease and low levels of low-density lipoprotein [LDL] cholesterol treated with 80 mg atorvastatin a day compared to 10 mg a day in a very large RCT¹⁶³Wenger NK, Lewis SJ, Herrington DM, Bittner V, Welty FK; Treating to New Targets Study Steering Committee and Investigators. Outcomes of using high- or low-dose atorvastatin in patients 65 years of age or older with stable coronary heart disease. Annals of Internal Medicine. 2007 Jul 3;147(1):1-9.
Lower risk of death from coronary heart disease or nonfatal heart attack (myocardial infarction) over 10 years among men with high cholesterol (hypercholesterolemia) treated with pravastatin compared to placebo in a very large RCT¹⁶⁴Ford I, Murray H et al; West of Scotland Coronary Prevention Study Group. Long-term follow-up of the West of Scotland Coronary Prevention Study. New England Journal of Medicine. 2007 Oct 11;357(15):1477-86.
15% lower incidence of coronary events (coronary death, non-fatal myocardial infarction, and fatal or non-fatal stroke) among people with a history of or risk factors for vascular disease treated with 40 mg pravastatin a day for more than 3 years compared to placebo in a very large RCT¹⁶⁵Shepherd J, Blauw GJ et al; PROSPER study group. PROspective Study of Pravastatin in the Elderly at Risk. Pravastatin in elderly individuals at risk of vascular disease (PROSPER): a randomised controlled trial. Lancet. 2002 Nov 23;360(9346):1623-30.
Fewer cardiovascular events (death, heart attack (myocardial infarction), unstable angina, and stroke among people with coronary heart disease treated with pravastatin compared to placebo in a very large RCT¹⁶⁶Hunt D, Young P et al. Benefits of pravastatin on cardiovascular events and mortality in older patients with coronary heart disease are equal to or exceed those seen in younger patients: results from the LIPID trial. Annals of Internal Medicine. 2001 May 15;134(10):931-40.
24% lower incidence of a fatal coronary event or a nonfatal heart attack (myocardial infarction), 26% lower incidence of coronary bypass surgery, 23% lower incidence of coronary angioplasty, and 31% lower incidence of stroke after a heart attack, with stronger effects among women or people with higher baseline levels of LDL cholesterol, among people treated pravastatin compared to placebo in a very large RCT¹⁶⁷Sacks FM, Pfeffer MA et al. The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels. Cholesterol and Recurrent Events Trial investigators. New England Journal of Medicine. 1996 Oct 3;335(14):1001-9.

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on blood pressure among women with metabolic syndrome treated with atorvastatin in one small study

No evidence of an effect on blood pressure among women with metabolic syndrome treated with 80 mg atorvastatin for 12 weeks compared to placebo in a small RCT¹⁶⁸Velarde GP, Choudhary N et al. Effect of atorvastatin on lipogenic, inflammatory and thrombogenic markers in women with the metabolic syndrome. Nutrition, Metabolism, and Cardiovascular Diseases. 2021 Feb 8;31(2):634-640.

No evidence of an effect on markers of cardiovascular function among people with type 2 diabetes and dyslipidemia treated with atorvastatin in one study

No evidence of an effect on markers of cardiovascular function (whole-body synthesis of nitric oxide, prostacyclin, and thromboxane A2) among people with type 2 diabetes and dyslipidemia treated with either 10 or 80 mg atorvastatin per day for 30 weeks compared to placebo in a mid-sized RCT¹⁶⁹Tsikas D, Pham VV et al; DALI-Study Group. No effects of atorvastatin (10 mg/d or 80 mg/d) on nitric oxide, prostacyclin, thromboxane and oxidative stress in type 2 diabetes mellitus patients of the DALI study. Pharmacological Research. 2015 Apr;94:1-8.

Cognitive side effects

Also see evidence of worse cognitive performance linked to statin use in Safety and precautions ›

17% lower risk of all-cause dementia (either Alzheimer disease or vascular dementia) among people treated with statins compared to no statins in a very large meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 30 observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods studies¹⁷⁰Poly TN, Islam MM et al. Association between use of statin and risk of dementia: a meta-analysis of observational studies. Neuroepidemiology. 2020;54(3):214-226.

Hospitalizations

No evidence of an effect on the rate of hospitalizations from small bowel obstructions after colorectal surgery among people treated with simvastatin for a few days before surgery in a small study

No evidence of an effect on the rate of hospitalizations from small bowel obstructions for 2 years after colorectal surgery among people treated with 40 mg oral simvastatin once a day for 3 to 7 days before surgery compared to placebo in a small RCT¹⁷¹Alexander ZE, Su’a B et al. The effect of oral simvastatin on fibrinolytic activity after colorectal surgery-a pilot study. Journal of Surgical Research. 2016 Sep;205(1):28-32.

Mortality among people with sepsis

No evidence of an effect on in-hospital mortality or 28-day hospital mortality among people with sepsis treated with statins in combined analyses of studies

No evidence of an effect on in-hospital mortality (7 studies) or 28-day hospital mortality (5 studies) among people with sepsis treated with statins compared to no statins in meta-analyses of RCTs¹⁷²Chen M, Ji M, Si X. The effects of statin therapy on mortality in patients with sepsis: a meta-analysis of randomized trials. Medicine (Baltimore). 2018 Aug;97(31):e11578.

Reducing cancer risk

Are statins linked to lower risks of developing cancer or of recurrence? We present the evidence.

Cancer as a whole

People with cancer treated with statins show a lower risk of recurrence, although most evidence does not show any effect on risk of cancer or ultimate cancer mortality.

Recurrence: good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) of moderately lower risk of recurrence among people with cancer treated with statins

26% lower risk of recurrence (higher recurrence-free survival and higher disease-free survival) among people with cancer treated with statins compared to no statin use in a very large meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 55 observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods studies¹⁷³Mei Z, Liang M et al. Effects of statins on cancer mortality and progression: a systematic review and meta-analysis of 95 cohorts including 1,111,407 individuals. International Journal of Cancer. 2017 Mar 1;140(5):1068-1081.

Cancer risk: insufficient evidencepreclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example) (this is the CancerChoices definition; other researchers and studies may define this differently) of an effect on risk of cancer or ultimate cancer mortality among people treated with statins in combined analyses of many studies

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on risk of cancer (28 studies) or on cancer mortality (18 studies) among people treated with statins compared to controls in meta-analyses of RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects¹⁷⁴Chen Z, Wu P et al. The association of statin therapy and cancer: a meta-analysis. Lipids in Health and Disease. 2023 Nov 10;22(1):192.
No evidence of an effect on risk of cancer or on cancer mortality among people treated with statins compared to no statins in a very large meta-analyses 5 RCTs and 10 observational studies¹⁷⁵Craveiro NS, Silva Lopes B et al. L-TRUST: Long-term risk of cancer in patients under statins therapy. A systematic review and meta-analysis. Pharmacoepidemiology and Drug Safety. 2019 Nov;28(11):1431-1439.
No evidence of effect on risk or mortality from any of 23 cancer types or cancer as a whole among people lowering LDL cholesterol with statins for an average of about 5 years in a very large meta-analysis of RCTs¹⁷⁶Cholesterol Treatment Trialists’ (CTT) Collaboration; Emberson JR, Kearney PM et al. Lack of effect of lowering LDL cholesterol on cancer: meta-analysis of individual data from 175,000 people in 27 randomised trials of statin therapy. PLoS One. 2012;7(1):e29849.
No evidence of an effect on cancer incidence or mortality during more than 5 years of follow up among people at high risk of vascular and non-vascular outcomes treated with 40 mg simvastatin daily compared to placeboa pill, medicine, or procedure—thought to be both harmless and ineffective—prescribed for the psychological benefit to the patient or as a sham treatment in a study to allow a comparison to a therapy of interest in a very large RCT¹⁷⁷Heart Protection Study Collaborative Group. Effects on 11-year mortality and morbidity of lowering LDL cholesterol with simvastatin for about 5 years in 20,536 high-risk individuals: a randomised controlled trial. Lancet. 2011 Dec 10;378(9808):2013-2020.
No evidence of an effect on cancer incidence or mortality among people treated with statins for at least 2 years compared to no statins in a large meta-analysis of 26 RCTs¹⁷⁸Cholesterol Treatment Trialists’ (CTT) Collaboration; Baigent C, Blackwell L et al. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet. 2010 Nov 13;376(9753):1670-81.
22% lower cancer mortality but only a weak trend toward lower cancer incidence among postmenopausal women without cancer at baseline treated with either hydrophilic or lipophilic statins compared to no statins in a very large observational study¹⁷⁹Wang A, Aragaki AK et al. Statin use and all-cancer mortality: prospective results from the Women’s Health Initiative. Journal of Clinical Oncology. 2015 May;33(15suppl):1506-1506.
A weak trendan apparent change due to a therapy, close to but not achieving full statistical significance (this is the CancerChoices definition; other researchers and studies may define this differently toward lower cancer mortality among people with hyperlipidaemia treated with statins compared to no statins in a very large observational study¹⁸⁰Yokomichi H, Nagai A et al. Statin use and all-cause and cancer mortality: BioBank Japan cohort. Journal of Epidemiology. 2017 Mar;27(3S):S84-S91.
No evidence of an effect on cancer incidence or mortality among people with coronary heart disease, serum total cholesterol 5.5-8.0 mmol/L, and serum triglycerides 2.5 mmol/L or lower treated with simvastatin compared to placebo in a large RCT¹⁸¹Strandberg TE, Pyörälä K et al; 4S Group. Mortality and incidence of cancer during 10-year follow-up of the Scandinavian Simvastatin Survival Study (4S). Lancet. 2004 Aug 28-Sep 3;364(9436):771-7.
Lower risk of cancer among people treated with statins for more than 4 years compared to no statins in a very large observational study¹⁸²Graaf MR, Beiderbeck AB, Egberts AC, Richel DJ, Guchelaar HJ. The risk of cancer in users of statins. Journal of Clinical Oncology. 2004 Jun 15;22(12):2388-94.

Bladder cancer

People treated with statins have not shown a lower risk of bladder cancer.

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on risk of bladder cancer among people treated with statins in combined analyses of studies

No evidence of an effect on risk of bladder cancer among people treated with statins compared to controls in meta-analysesstatistical analyses that combine the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 4 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects and of 6 observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods studies¹⁸³Symvoulidis P, Tsioutis C, Zamboglou C, Agouridis AP. The effect of statins on the incidence and prognosis of bladder cancer: a systematic review and meta-analysis. Current Oncology. 2023 Jul 12;30(7):6648-6665.
No evidence of an effect on risk of recurrence among people with bladder cancer treated with statins compared to no statins in a meta-analysis of 3 observational studies¹⁸⁴Luo Y, She DL, Xiong H, Fu SJ, Yang L. The prognostic effect of statin use on urologic cancers: an updated meta-analysis of 35 observational studies. Medicine (Baltimore). 2015 Sep;94(36):e1523.
No evidence of an effect on risk of bladder cancer among people treated with statins compared to no statins in a very large meta-analysis of 3 RCTs and 10 observational studies¹⁸⁵Jeong GH, Lee KH et al. Effect of statin on cancer incidence: an umbrella systematic review and meta-analysis. Journal of Clinical Medicine. 2019 Jun 8;8(6):819.

Blood cancers

People treated with statins have a moderately lower risk of leukemia, myeloma, or blood cancers as a whole.

Blood cancer as a whole: good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) of slightly to moderately lower risk of blood cancers as a whole among people treated with statins in observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods studies, but no evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. in RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects. Our note: the study population is often different in RCTs compared to observational studies.

12% lower risk of blood (hematological) cancer among people treated with statins compared to no statins in a large meta-analysis of 26 observational studies but no evidence of an effect on risk in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 8 RCTs¹⁸⁶Jeong GH, Lee KH et al. Effect of statin on cancer incidence: an umbrella systematic review and meta-analysis. Journal of Clinical Medicine. 2019 Jun 8;8(6):819.
14% lower risk of blood (hematological) cancer among people treated with statins compared to no statins in a large meta-analysis of 14 observational studies¹⁸⁷Pradelli D, Soranna D et al. Statins use and the risk of all and subtype hematological malignancies: a meta-analysis of observational studies. Cancer Medicine. 2015 May;4(5):770-80.
21% lower risk of blood cancers among people treated with statins compared to no statins in a meta-analysis of 14 observational studies, but no evidence of an effect in a meta-analysis of 6 RCTs¹⁸⁸Yi X, Jia W, Jin Y, Zhen S. Statin use is associated with reduced risk of haematological malignancies: evidence from a meta-analysis. PLoS One. 2014 Jan 31;9(1):e87019.
22% lower risk of blood cancer among people treated with statins compared to no statins in a large combined analysis of observational studies¹⁸⁹Vinogradova Y, Coupland C, Hippisley-Cox J. Exposure to statins and risk of common cancers: a series of nested case-control studies. BMC Cancer. 2011 Sep 26;11:409.

Leukemia: good evidence of slightly lower risk of leukemia among people treated with statins

15% lower risk of leukemia among people treated with statins compared to no statins in a meta-analysis of 96 observational studies¹⁹⁰Jeong GH, Lee KH et al. Effect of statin on cancer incidence: an umbrella systematic review and meta-analysis. Journal of Clinical Medicine. 2019 Jun 8;8(6):819.
17% lower risk of leukemia among people treated with statins compared to no statins in a meta-analysis of 9 observational studies¹⁹¹Pradelli D, Soranna D et al. Statins use and the risk of all and subtype hematological malignancies: a meta-analysis of observational studies. Cancer Medicine. 2015 May;4(5):770-80.

Myeloma: modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of a moderately lower risk of myeloma among people treated with statins

23% lower risk of myeloma among people treated with statins compared to no statins in a meta-analysis of 8 observational studies¹⁹²Zhang P, Liu B. Statin use and the risk of multiple myeloma: a PRISMA-compliant meta-analysis. Annals of Hematology. 2020 Aug;99(8):1805-1812.
20% lower risk of myeloma among people treated with statins compared to no statins in a meta-analysis of 10 observational studies¹⁹³Ponvilawan B, Charoenngam N, Rittiphairoj T, Ungprasert P. Receipt of statins is associated with lower risk of multiple myeloma: systematic review and meta-analysis. Clinical Lymphoma, Myeloma & Leukemia. 2020 Jul;20(7):e399-e413.
No evidence of an effect on risk of myeloma among people treated with statins compared to no statins in a meta-analysis of 5 observational studies¹⁹⁴Pradelli D, Soranna D et al. Statins use and the risk of all and subtype hematological malignancies: a meta-analysis of observational studies. Cancer Medicine. 2015 May;4(5):770-80.

Brain cancer

People treated with statins have not shown any lower risk of glioma.

Breast cancer

People with breast cancer, including triple-negative breast cancer, treated with statins show lower risk of recurrence. However, evidence so far does not show a lower risk of breast cancer incidence or mortality with statin use.

24% lower risk of recurrence among people with breast cancer treated with statins after a cancer diagnosis compared to no statins, rising to 37% lower risk among people using lipophilic statins, in a very large meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 15 observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods studies¹⁹⁶Jaiswal V, Agrawal V et al. Post-diagnostic statin use and its association with cancer recurrence and mortality in breast cancer patients: a systematic review and meta-analysis. European Heart Journal. Cardiovasccular Pharmacotherapy. 2023 Dec 14;9(8):731-740.
25% lower risk of breast cancer recurrence among people treated with statins compared to no statins in a meta-analysis of 10 observational studies and RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects¹⁹⁷Zhao G, Ji Y et al. Effect of statins use on risk and prognosis of breast cancer: a meta-analysis. Anticancer Drugs. 2022 Jan 1;33(1):e507-e518.
26% lower risk of recurrence among people with breast cancer treated with statins after a cancer diagnosis compared to no statins in a large meta-analysis of 7 observational studies¹⁹⁸Xu WH, Zhou YH. The relationship between post-diagnostic statin usage and breast cancer prognosis varies by hormone receptor phenotype: a systemic review and meta-analysis. Archives of Gynecology and Obstetrics. 2021 Nov;304(5):1315-1321.
28% lower risk of breast cancer recurrence, and even lower risk in the first five years, among women with breast cancer treated with statins compared to no statins in a very large meta-analysis of 17 observational studies¹⁹⁹Lv H, Shi D et al. Association between statin use and prognosis of breast cancer: a meta-analysis of cohort studies. Frontiers in Oncology. 2020 Oct 16;10:556243.
28% lower risk of recurrence (better recurrence-free survival) among people with breast cancer treated with lipophilic statins (especially simvastatin) but no evidence of an effect of hydrophilic statins compared to no statins in a meta-analysis of 10 observational studies²⁰⁰Manthravadi S, Shrestha A, Madhusudhana S. Impact of statin use on cancer recurrence and mortality in breast cancer: a systematic review and meta-analysis. International Journal of Cancer. 2016 Sep 15;139(6):1281-8.
Moderately lower risk of recurrence among people with breast cancer treated with statins compared to no statins in a very large meta-analysis of 6 observational studies²⁰¹Mansourian M, Haghjooy-Javanmard S et al. Statins use and risk of breast cancer recurrence and death: a systematic review and meta-analysis of observational studies. Journal of Pharmacy and Pharmaceutical Sciences. 2016;19(1):72-81.

Lower risk of recurrence (higher disease-free survival) at 5 years after oncologic treatment for curative intent among people with triple negative breast cancer treated with statins compared to no statins in a meta-analysis of 5 observational studies²⁰²McKechnie T, Brown Z et al. Concurrent use of statins in patients undergoing curative intent treatment for triple negative breast cancer: a systematic review and meta-analysis. Clinical Breast Cancer. 2024 Apr;24(3):e103-e115.

Cancer risk: insufficient evidencepreclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example) (this is the CancerChoices definition; other researchers and studies may define this differently) of an effect on lower risk of breast cancer incidence or mortality among people treated with statins across many studies

Also see evidence of higher risk of breast cancer among people using statins in Safety and precautions ›

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on risk of breast cancer among people treated with statins compared to no statins in a meta-analysis of 44 observational studies and RCTs²⁰³Zhao G, Ji Y et al. Effect of statins use on risk and prognosis of breast cancer: a meta-analysis. Anticancer Drugs. 2022 Jan 1;33(1):e507-e518.
12% lower risk of breast cancer and 35% lower breast cancer mortality among people without cancer at baseline treated with statins for at least 6 months compared to no statins in a very large observational study²⁰⁴Kim DS, Ahn HS, Kim HJ. Statin use and incidence and mortality of breast and gynecology cancer: a cohort study using the National Health Insurance claims database. International Journal of Cancer. 2022 Apr 1;150(7):1156-1165.
Slightly lower risk of breast cancer among people treated with statins compared to no statins in a very large meta-analysis of 50 observational studies but no evidence of an effect on risk in a meta-analysis of 12 RCTs²⁰⁵Jeong GH, Lee KH et al. Effect of statin on cancer incidence: an umbrella systematic review and meta-analysis. Journal of Clinical Medicine. 2019 Jun 8;8(6):819.
No evidence of an effect on risk of breast cancer among people treated with statins compared to no statins in a very large meta-analysis of 36 observational studies²⁰⁶Islam MM, Yang HC et al. Exploring association between statin use and breast cancer risk: an updated meta-analysis. Archives of Gynecology and Obstetrics. 2017 Dec;296(6):1043-1053.
Lower breast cancer mortality among postmenopausal women without cancer at baseline treated with either hydrophilic or lipophilic statins compared to no statins in a very large observational study²⁰⁷Wang A, Aragaki AK et al. Statin use and all-cancer mortality: prospective results from the Women’s Health Initiative. Journal of Clinical Oncology. 2015 May;33(15suppl):1506-1506.
No evidence of an effect on risk of breast cancer among people treated with statins compared to no statins in a very large meta-analysis of 24 observational studies²⁰⁸Undela K, Srikanth V, Bansal D. Statin use and risk of breast cancer: a meta-analysis of observational studies. Breast Cancer Research and Treatment. 2012 Aug;135(1):261-9.

Colorectal cancer

Treatment with statins has not led to lower risk of recurrence among people with colorectal cancer. Statin use leads to slightly lower risk of advanced adenoma and substantially lower overall risk of colorectal cancer among people with inflammatory bowel diseases. Statin use does not show a clear effect on risk of colorectal cancer overall, although people using lipophilic statins show moderately lower risk.

Recurrence: no evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on risk of recurrence among people with colorectal cancer treated with statins

No evidence of an effect on risk of recurrence (recurrence-free survival or disease-free survival) after neoadjuvanttherapy used before a main treatment, such as chemotherapy, radiation therapy, and hormone therapy before surgery chemoradiotherapy and resection for rectal cancer among people treated with statins compared to no statins in a mid-sized observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods study²⁰⁹Fransgaard T, Hallas J, Thygesen LC, Gögenur I. Association of statin use and oncological outcomes after neoadjuvant radiotherapy in patients with rectal cancer. Anticancer Research. 2019;39(4):2177–2182.
No evidence of an effect on recurrence or new primary cancer at any anatomic site among adults with stage 1–3A colon cancer treated with statins compared to no statins in a large observational study²¹⁰Bowles EJA, Yu O et al. Cardiovascular medication use and risks of colon cancer recurrences and additional cancer events: a cohort study. BMC Cancer. 2019;19(1):270.
No evidence of an effect on recurrence among people with colorectal cancer treated with statins during the preceding year compared to no statins in a very large observational study²¹¹Lash TL, Riis AH et al. Associations of statin use with colorectal cancer recurrence and mortality in a Danish cohort. American Journal of Epidemiology. 2017 Sep 15;186(6):679-687.
No evidence of an effect on recurrence (recurrence-free survival or disease-free survival) among people with colorectal cancer treated with statins after a cancer diagnosis (4 studies) compared to no statins in large meta-analysesstatistical analyses that combine the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of observational studies²¹²Cai H, Zhang G, Wang Z, Luo Z, Zhou X. Relationship between the use of statins and patient survival in colorectal cancer: a systematic review and meta-analysis. PLoS One. 2015 Jun 1;10(6):e0126944.

Cancer incidence or mortality

Also see evidence of higher risk of colorectal cancer among people treated with statins in Safety and precautions ›

No evidence of an effect on risk of proximal cancer among people treated with statins compared to no statins in a meta-analysis of 3 observational studies²¹³Harewood R, Disney R, Kinross J, von Wagner C, Cross AJ. Medication use and risk of proximal colon cancer: a systematic review of prospective studies with narrative synthesis and meta-analysis. Cancer Causes and Control. 2021 Oct;32(10):1047-1061.
Slightly lower risk of rectal cancer but no evidence of an effect on risk of colorectal cancer overall among people ever treated with statins compared to no statins in a very large observational study²¹⁴Ibáñez-Sanz G, Guinó E et al. Statin use and the risk of colorectal cancer in a population-based electronic health records study. Scientific Reports. 2019;9(1):13560.
Slightly lower risk of colorectal cancer among adults treated with statins compared to no statins, and stronger effects with higher numbers of doses, in a very large observational study²¹⁵Lai SW, Kuo YH, Fang CW, Liao KF. Statins therapy and colorectal cancer risk. Nutrition, Metabolism & Cardiovascular Diseases. 2019;29(12):1429–1430.
Slightly lower risk of colorectal cancer among people treated with statins compared to no statins in a very large meta-analysis of 46 observational studies but no evidence of an effect on risk in a meta-analysis of 13 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects²¹⁶Jeong GH, Lee KH et al. Effect of statin on cancer incidence: an umbrella systematic review and meta-analysis. Journal of Clinical Medicine. 2019 Jun 8;8(6):819.
A weak trendan apparent change due to a therapy, close to but not achieving full statistical significance (this is the CancerChoices definition; other researchers and studies may define this differently toward lower colorectal cancer mortality among people with hyperlipidaemia treated with statins compared to no statins in a very large observational study²¹⁷Yokomichi H, Nagai A et al. Statin use and all-cause and cancer mortality: BioBank Japan cohort. Journal of Epidemiology. 2017 Mar;27(3S):S84-S91.
Slightly lower risk of colorectal cancer among people treated with statins compared to no statins, but no evidence of an effect among people who continued use of statins compared to people who discontinued use in a very large observational study²¹⁸Mamtani R, Lewis JD et al. Disentangling the association between statins, cholesterol, and colorectal cancer: a nested case-control study. PLoS Medicine. 2016 Apr 26;13(4):e1002007.
Lower colorectal cancer mortality among postmenopausal women without cancer at baseline treated with either hydrophilic or lipophilic statins compared to no statins in a very large observational study²¹⁹Wang A, Aragaki AK et al. Statin use and all-cancer mortality: prospective results from the Women’s Health Initiative. Journal of Clinical Oncology. 2015 May;33(15suppl):1506-1506.
Moderately lower risk of colorectal cancer among people treated with statins compared to no statins in a very large observational study²²⁰Sehdev A, Shih YC et al. The role of statins for primary prevention in non-elderly colorectal cancer patients. Anticancer Research. 2014 Sep;34(9):5043-50.
11% lower risk of colorectal cancer as a whole among people treated with statins compared to no statins in a meta-analysis of 31 observational studies but no evidence of an effect on risk of colon cancer in a meta-analysis of 11 RCTs²²¹Liu Y, Tang W et al. Association between statin use and colorectal cancer risk: a meta-analysis of 42 studies. Cancer Causes and Control. 2014 Feb;25(2):237-49.
No evidence of an effect on risk of colorectal cancer among people treated with statins in a large meta-analysis of 8 RCTs, although about 8% or 9% lower risk in large meta-analyses of 13 and 19 observational studies²²²Lytras T, Nikolopoulos G, Bonovas S. Statins and the risk of colorectal cancer: an updated systematic review and meta-analysis of 40 studies. World Journal of Gastroenterology. 2014 Feb 21;20(7):1858-70.
9% lower risk of colorectal cancer among people treated with statins compared to no statins in a very large meta-analysis of 11 RCTs and 19 observational studies²²³Bardou M, Barkun A, Martel M. Effect of statin therapy on colorectal cancer. Gut. 2010 Nov;59(11):1572-85.
No evidence of an effect on risk of colorectal cancer among people treated with statins compared to controls in a large meta-analysis of 6 RCTs, although an 8% lower risk of colorectal cancer was seen in a very large meta-analysis of 12 observational studies²²⁴Bonovas S, Filioussi K, Flordellis CS, Sitaras NM. Statins and the risk of colorectal cancer: a meta-analysis of 18 studies involving more than 1.5 million patients. Journal of Clinical Oncology. 2007 Aug 10;25(23):3462-8.

Substantially lower risk of colorectal cancer among people with inflammatory bowel diseases treated with statins compared to no statins in a very large observational study²²⁵Ananthakrishnan AN, Cagan A et al. Statin use is associated with reduced risk of colorectal cancer in patients with inflammatory bowel diseases. Clinical Gastroenterology and Hepatology. 2016 Jul;14(7):973-9.

Good evidence of slightly lower risk of advanced colorectal adenoma but no evidence of an effect on adenoma overall among people treated with statins

17% lower risk of advanced colorectal adenoma but no evidence of an effect on adenoma overall among people treated with statins compared to no statins in a large meta-analysis of 6 observational studies²²⁶Jung YS, Park CH, Eun CS, Park DI, Han DS. Statin use and the risk of colorectal adenoma: a meta-analysis. Journal of Gastroenterology and Hepatology. 2016 Nov;31(11):1823-1830.

Good evidence of moderately lower risk of colorectal cancer among people treated with lipophilic statins

Moderately lower risk of colorectal cancer among people treated with statins compared to no statins, especially lipid-soluble statins, in a very large meta-analysis of 31 RCTs and observational studies²²⁷Qi JH, Wei JN et al. [A meta-analysis on association between statins and colorectal cancer]. Zhonghua Liu Xing Bing Xue Za Zhi. 2021 Feb 10;42(2):343-350. Chinese.
20% lower risk of diagnosis with late-stage colorectal cancer among postmenopausal women treated with lipophilic statins compared to no statins, and a weak trend toward lower risk compared to hydrophilic statins, in a large observational study²²⁸Rutledge BP, Desai P et al. The association between statins and colorectal cancer stage in the Women’s Health Initiative. Molecular and Clinical Oncology. 2019;11(3):252–258.
12% lower risk of colorectal cancer among people treated with lipophilic statins compared to no statins in a meta-analysis of 31 observational studies²²⁹Liu Y, Tang W et al. Association between statin use and colorectal cancer risk: a meta-analysis of 42 studies. Cancer Causes and Control. 2014 Feb;25(2):237-49.

Gastrointestinal cancer

Colorectal cancer and pancreatic cancer are listed separately.

People treated with statins have lower mortality from digestive cancers as a whole.

People with esophageal cancer treated with statins as a whole show lower risk of recurrence, especially obese people, but no benefit is seen from simvastatin. Statins lead to a lower risk of esophageal cancer or of Barrett’s esophagus, a risk factor for esophageal cancer, and of progression from Barrett’s esophagus to cancer.

People treated with statins show a moderately lower risk of biliary tract cancers as a whole, and especially bile duct cancer and gallbladder cancer.

People with liver cancer treated with statins show a moderately lower risk of recurrence.

People treated with statins show moderately lower risk of liver cancer, including people with chronic liver disease (cirrhosis, hepatitis B virus, or hepatitis C virus infections, or nonalcoholic fatty liver disease).

People treated with statins have a lower risk of stomach cancer, although no evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. in RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects. People treated with simvastatin after antibiotic treatment for Helicobacter pylori (H. pylori) have also shown higher rates of eradication of H. pylori—a risk factor for stomach cancer.

Gastrointestinal cancer as a whole: good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) of lower mortality from digestive cancers as a whole among postmenopausal women treated with statins

Lower mortality from digestive cancer among postmenopausal women without cancer at baseline treated with either hydrophilic or lipophilic statins compared to no statins in a very large observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods study²³⁰Wang A, Aragaki AK et al. Statin use and all-cancer mortality: prospective results from the Women’s Health Initiative. Journal of Clinical Oncology. 2015 May;33(15suppl):1506-1506.

Esophageal cancer

Recurrence

Good evidence of lower risk of recurrence among people with esophageal cancer treated with statins

16% lower risk of recurrence (better disease-free survival) among people with esophageal cancer—either esophageal adenocarcinoma or esophageal squamous cell carcinoma—treated with statins in a large meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 5 observational studies.²³¹Zhou C, Zhong X et al. Statin use and its potential therapeutic role in esophageal cancer: a systematic review and meta-analysis. Cancer Management and Research. 2019 Jun 19;11:5655-5663.

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of lower risk of recurrence after esophagectomy among people treated with statins, especially obese people, but not simvastatin

62% lower risk of recurrence (recurrence-free survival) after esophagectomy among obese people, but no evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. among non-obese people with esophageal cancer treated with statins before surgery compared to no statins in a mid-sized observational study²³²Abdelfatah E, Kukar M, Mukherjee S, Groman A, Yendamuri S. The anticancer effect of statins in obese esophageal cancer patients undergoing esophagectomy. Journal of Surgical Oncology. 2022 Aug;126(2):268-278.
No evidence of an effect on recurrence (disease-free survival) after esophagectomy among people with esophageal adenocarcinoma treated with 40 mg simvastatin after surgery for up to 1 year compared to placeboa pill, medicine, or procedure—thought to be both harmless and ineffective—prescribed for the psychological benefit to the patient or as a sham treatment in a study to allow a comparison to a therapy of interest in a small RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects²³³Alexandre L, Clark AB et alR. Adjuvant statin therapy for oesophageal adenocarcinoma: the STAT-ROC feasibility study. BJS Open. 2020 Feb;4(1):59-70.

Cancer risk

Good evidence of moderately lower risk of esophageal cancer among people treated with statins compared to no statins

28% lower risk of esophageal cancer among people treated with statins compared to no statins in a very large meta-analysis of 12 observational studies and a post-hoc analysis of 22 RCTs²³⁴Singh S, Singh AG, Singh PP, Murad MH, Iyer PG. Statins are associated with reduced risk of esophageal cancer, particularly in patients with Barrett’s esophagus: a systematic review and meta-analysis. Clinical Gastroenterology and Hepatology. 2013 Jun;11(6):620-9.
31% lower risk of esophageal cancer among people treated with statins compared to no statins in a large meta-analysis of 26 observational studies²³⁵Jeong GH, Lee KH et al. Effect of statin on cancer incidence: an umbrella systematic review and meta-analysis. Journal of Clinical Medicine. 2019 Jun 8;8(6):819.
42% lower risk of esophageal adenocarcinoma, 71% lower risk of esophagogastric junctional adenocarcinoma (with high-dose use only), and 49% lower risk of esophageal squamous cell cancer (with use for 1–4 years) among people treated with statins compared to controls in a large observational study²³⁶Alexandre L, Clark AB et al. Statin use is associated with reduced risk of histologic subtypes of esophageal cancer: a nested case-control analysis. Gastroenterology. 2014 Mar;146(3):661-8.

Strong evidenceconsistent, significant effects in several large (or at least one very large) well designed clinical studies or at least two meta-analyses of clinical studies of moderate or better quality (or one large meta-analysis) finding similar results (this is the CancerChoices definition; other researchers and studies may define this differently) of moderately lower risk of esophageal cancer among people with Barrett’s esophagus—a risk factor for esophageal cancer—treated with statins

41% lower risk of esophageal cancer among people with Barrett’s esophagus treated with statins compared to no statins in a very large meta-analysis of 10 RCTs²³⁷Thomas T, Loke Y, Beales ILP. Systematic review and meta-analysis: use of statins is associated with a reduced incidence of oesophageal adenocarcinoma. Journal of Gastrointestinal Cancer. 2018 Dec;49(4):442-454.
Moderately lower risk of progression of Barrett’s esophagus among people treated with statins compared to no statins in a meta-analysis of 3 observational studies²³⁸Krishnamoorthi R, Singh S et al. Factors associated with progression of Barrett’s esophagus: a systematic review and meta-analysis. Clinical Gastroenterology and Hepatology. 2018 Jul;16(7):1046-1055.e8.

Good evidence of lower risk of Barrett’s esophagus, a risk factor for esophageal cancer, among people treated with statins

26% lower risk of Barrett’s esophagus among people treated with statins compared to no statins in a meta-analysis of 4 observational studies²³⁹Zhao Z, Yin Z, Zhang C. Lifestyle interventions can reduce the risk of Barrett’s esophagus: a systematic review and meta-analysis of 62 studies involving 250,157 participants. Cancer Medicine. 2021;10(15):5297-5320.
Moderately lower risk of Barrett’s esophagus among males regularly treated with statins compared to no statins in a combined analysis of 4 observational studies²⁴⁰Beales IL, Dearman L, Vardi I, Loke Y. Reduced risk of Barrett’s esophagus in statin users: case-control study and meta-analysis. Digestive Diseases and Sciences. 2016 Jan;61(1):238-46.

Gallbladder or other biliary tract cancers: good evidence of moderately lower risk of biliary tract cancers as a whole, and especially bile duct cancer and gallbladder cancer, among people treated with statins

33% lower risk of all biliary tract cancers, and especially bile duct cancer (cholangiocarcinoma) and gallbladder cancer, among people treated with statins compared to no statins in a very large meta-analysis of 8 observational studies²⁴¹Cheung KS, Yeung YWM et al. Statins associate with lower risk of biliary tract cancers: a systematic review and meta-analysis. Cancer Medicine. 2023 Jan;12(1):557-568.

Liver cancer

Recurrence: good evidence of moderately lower risk of recurrence among people with liver cancer treated with statins

45% lower risk of recurrence among people with liver cancer (hepatocellular carcinoma) treated with statins compared to no statins in a large meta-analysis of 5 observational studies²⁴²Li X, Liu L, Hu Y. Statin use and the prognosis of patients with hepatocellular carcinoma: a meta-analysis. Bioscience Reports. 2020 Apr 30;40(4):BSR20200232.
Moderately lower risk of recurrence among people with liver cancer treated with statins compared to no statins in a large network meta-analysis of 5 observational studies²⁴³Zhou YY, Zhu GQ et al. Systematic review with network meta-analysis: statins and risk of hepatocellular carcinoma. Oncotarget. 2016 Apr 19;7(16):21753-62.

Cancer risk

Good evidence of moderately lower risk of liver cancer among people treated with statins, with varying effects from individual statins, although no evidence of an effect in combined analyses of RCTs

Substantially lower risk of liver cancer among people treated with statins—atorvastatin, simvastatin, lovastatin, pitavastatin, or rosuvastatin, but not fluvastatin, cerivastatin, or pravastatin—compared to no statins in a meta-analysis of 11 observational studies²⁴⁴Zhang X, Lou D et al. Association between statins types with incidence of liver cancer: an updated meta-analysis. Current Medicinal Chemistry. 2024;31(6):762-775.
42% lower risk of liver cancer (hepatocellular carcinoma) among people treated with statins compared to no statins in a very large meta-analysis of 10 observational studies²⁴⁵Zeng RW, Yong JN et al. Meta-analysis: Chemoprevention of hepatocellular carcinoma with statins, aspirin and metformin. Alimentary Pharmacology & Therapeutics. 2023 Mar;57(6):600-609.
42% lower risk of liver cancer (hepatocellular carcinoma) among people treated with statins compared to controls or no statins in a large meta-analysis of 3 RCTs and 29 observational studies²⁴⁶Wang Y, Wang W et al. A meta-analysis of statin use and risk of hepatocellular carcinoma. Canadian Journal of Gastroenterology & Hepatology. 2022 Mar 20;2022:5389044.
46% lower risk of liver cancer (hepatocellular carcinoma) among people treated with statins compared to no statins in a very large meta-analysis of 18 observational studies²⁴⁷Chang Y, Liu Q et al. Can statin treatment reduce the risk of hepatocellular carcinoma? A systematic review and meta-analysis. Technology in Cancer Research & Treatment. 2020 Jan-Dec;19:1533033820934881.
43% lower risk of liver cancer among people treated with statins compared to no statins in a large meta-analysis of 24 observational studies but no evidence of an effect on risk in a meta-analysis of 3 RCTs²⁴⁸Jeong GH, Lee KH et al. Effect of statin on cancer incidence: an umbrella systematic review and meta-analysis. Journal of Clinical Medicine. 2019 Jun 8;8(6):819.
54% lower risk of liver cancer among people treated with statins compared to no statins in a large meta-analysis of 6 observational studies²⁴⁹Yi C, Song Z, Wan M, Chen Y, Cheng X. Statins intake and risk of liver cancer: a dose-response meta analysis of prospective cohort studies. Medicine. 2017 Jul;96(27):e7435.
40% lower risk of primary liver cancer among people treated with statins compared to no statins in a meta-analysis of 21 observational studies but no evidence of an effect in a meta-analysis of post-hoc analyses of RCTs²⁵⁰Zhong GC, Liu Y, Ye YY, Hao FB, Wang K, Gong JP. Meta-analysis of studies using statins as a reducer for primary liver cancer risk. Scientific Reports. 2016 May 20;6:26256.
Moderately lower risk of liver cancer among people treated with fluvastatin (42% lower risk), atorvastatin (37% lower) compared to no statins in a large network meta-analysis of 5 observational studies²⁵¹Zhou YY, Zhu GQ et al. Systematic review with network meta-analysis: statins and risk of hepatocellular carcinoma. Oncotarget. 2016 Apr 19;7(16):21753-62.
42% lower risk of liver cancer among people treated with statins compared to no statins or controls in a very large meta-analysis of 11 observational studies but no evidence of an effect in an analysis from 20 RCTs²⁵²Shi M, Zheng H, Nie B, Gong W, Cui X. Statin use and risk of liver cancer: an update meta-analysis. BMJ Open. 2014 Sep 16;4(9):e005399.

Good evidence of lower risk of liver cancer among people with chronic liver disease (cirrhosis, hepatitis B virus, or hepatitis C virus infections, or nonalcoholic fatty liver disease) treated with statins

43% lower risk of liver cancer (hepatocellular carcinoma) among people with chronic liver disease (cirrhosis, hepatitis B virus, or hepatitis C virus infections) treated with statins compared to no statins in a very large meta-analysis of 13 observational studies²⁵³Wong YJ, Qiu TY, Ng GK, Zheng Q, Teo EK. Efficacy and safety of statin for hepatocellular carcinoma prevention among chronic liver disease patients: a systematic review and meta-analysis. Journal of Clinical Gastroenterology. 2021 Aug 1;55(7):615-623.
Moderately lower risk of liver cancer (hepatocellular carcinoma) among people with nonalcoholic fatty liver disease treated with statins compared to no statins in a very large meta-analysis of 5 observational studies²⁵⁴Zhang J, Fu S, Liu D, Wang Y, Tan Y. Statin can reduce the risk of hepatocellular carcinoma among patients with nonalcoholic fatty liver disease: a systematic review and meta-analysis. European Journal of Gastroenterology & Hepatology. 2023 Apr 1;35(4):353-358.
32% lower risk of liver cancer (hepatocellular carcinoma) among people with nonalcoholic fatty liver disease treated with statins compared to no statins in a very large meta-analysis of 2 observational studies²⁵⁵Zeng RW, Yong JN et al. Meta-analysis: Chemoprevention of hepatocellular carcinoma with statins, aspirin and metformin. Alimentary Pharmacology & Therapeutics. 2023 Mar;57(6):600-609.
47% lower risk of liver cancer (hepatocellular carcinoma) among people with hepatitis B (5 studies), and 21% lower risk among people with hepatitis C (3 studies) treated with statins compared to no statins in a meta-analyses of observational studies²⁵⁶Zeng RW, Yong JN et al. Meta-analysis: Chemoprevention of hepatocellular carcinoma with statins, aspirin and metformin. Alimentary Pharmacology & Therapeutics. 2023 Mar;57(6):600-609.
53% lower risk of liver cancer (hepatocellular carcinoma) among people with hepatitis B or C virus infection treated with statins compared to no statins in a meta-analysis of 7 observational studies²⁵⁷Li Z, Li Y et al. Statins in hepatitis B or C patients is associated with reduced hepatocellular carcinoma risk: a systematic review and meta-analysis. Turkish Journal of Gastroenterology. 2022 Feb;33(2):136-144.
Moderately lower risk of liver cancer (hepatocellular carcinoma) among people with hepatitis B (9 studies) or C (10 studies) virus infection treated with statins compared to controls or no statins in meta-analyses of observational studies²⁵⁸Wang Y, Wang W et al. A meta-analysis of statin use and risk of hepatocellular carcinoma. Canadian Journal of Gastroenterology & Hepatology. 2022 Mar 20;2022:5389044.
46% lower risk of liver cancer (hepatocellular carcinoma) among people with hepatitis B (7 studies) or C (7 studies) virus infection treated with statins compared to no statins, with evidence of stronger effects from lipophilic statins compared to hydrophilic statins in 3 studies, in very large meta-analyses of observational studies²⁵⁹Li X, Sheng L et al. Statin and the risk of hepatocellular carcinoma in patients with hepatitis B virus or hepatitis C virus infection: a meta-analysis. BMC Gastroenterology. 2020 Apr 9;20(1):98.
5% lower risk of liver cancer (hepatocellular carcinoma) among people with cirrhosis treated with statins compared to no statins in a large meta-analysis of 3 observational studies²⁶⁰Zeng RW, Yong JN et al. Meta-analysis: Chemoprevention of hepatocellular carcinoma with statins, aspirin and metformin. Alimentary Pharmacology & Therapeutics. 2023 Mar;57(6):600-609.
55% lower risk of liver cancer (hepatocellular carcinoma) among people with cirrhosis treated with statins compared to no statins in a meta-analysis of 3 observational studies²⁶¹Li Z, Li Y et al. Statins in hepatitis B or C patients is associated with reduced hepatocellular carcinoma risk: a systematic review and meta-analysis. Turkish Journal of Gastroenterology. 2022 Feb;33(2):136-144.

Stomach cancer: good evidence of moderately lower risk of stomach cancer among people treated with statins, although no evidence of an effect in combined analyses of RCTs

Moderately lower risk of stomach (gastric) cancer among people treated with statins compared to no statins in meta-analyses of 49 observational studies, but no evidence of an effect on risk in a meta-analysis of 2 RCTs²⁶²Chen Y, Zhang J, Zhang Y, Zhu L. Effect of statin use on risk and mortality of gastric cancer: a meta-analysis. Anticancer Drugs. 2023 Sep 1;34(8):901-909.
22% lower risk of stomach (gastric) cancer among people treated with statins, especially lipophilic statins, compared to no statins in a meta-analysis of 32 observational studies²⁶³Lou D, Fu R, Gu L, Su H, Guan L. Association between statins’ exposure with incidence and prognosis of gastric cancer: an updated meta-analysis. Expert Review of Clinical Pharmacology. 2022 Sep;15(9):1127-1138.
Moderately lower risk of stomach (gastric) cancer among people treated with statins compared to no statins in meta-analyses of 18 observational studies²⁶⁴Seo SI, Park CH et al. Aspirin, metformin, and statin use on the risk of gastric cancer: a nationwide population-based cohort study in Korea with systematic review and meta-analysis. Cancer Medicine. 2022 Feb;11(4):1217-1231.
34% lower risk of stomach cancer among people treated with statins compared to no statins in a meta-analysis of 6 observational studies but no evidence of an effect in a meta-analysis of 4 RCTs²⁶⁵Bae JM. Statin intake and gastric cancer risk: an updated subgroup meta-analysis considering immortal time bias. Journal of Preventive Medicine and Public Health. 2022 Sep;55(5):424-427.
29% lower risk of stomach (gastric) cancer among people treated with statins compared to no statins in a large meta-analysis of 13 observational studies but no evidence of an effect on risk in a meta-analysis of 3 RCTs²⁶⁶Jeong GH, Lee KH et al. Effect of statin on cancer incidence: an umbrella systematic review and meta-analysis. Journal of Clinical Medicine. 2019 Jun 8;8(6):819.
44% lower risk of stomach cancer among people treated with statins compared to no statins in a large meta-analysis of 6 observational studies²⁶⁷Ma Z, Wang W, Jin G, Chu P, Li H. Effect of statins on gastric cancer incidence: a meta-analysis of case control studies. Journal of Cancer Research and Therapeutics. 2014 Oct-Dec;10(4):859-65.
30% lower risk of stomach cancer among people treated with statins compared to no statins in a very large meta-analysis of 9 observational studies but no evidence of an effect in a meta-analysis of 3 RCTs²⁶⁸Wu XD, Zeng K, Xue FQ, Chen JH, Chen YQ. Statins are associated with reduced risk of gastric cancer: a meta-analysis. European Journal of Clinical Pharmacology. 2013 Oct;69(10):1855-60.
16% lower risk of stomach cancer among people treated with statins compared to no statins in a very large meta-analysis of 11 observational studies and analyses of RCTs²⁶⁹Singh PP, Singh S. Statins are associated with reduced risk of gastric cancer: a systematic review and meta-analysis. Annals of Oncology. 2013 Jul;24(7):1721-1730.

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of higher rates of eradication of Helicobacter pylori—a risk factor for stomach cancer—after antibiotic treatment among people treated with simvastatin

Higher rates of eradication of Helicobacter pylori after treatment with two antibiotics (500 mg clarithromycin and 1 g amoxicillin twice a day) plus a proton pump inhibitor (20 mg omeprazole twice daily) among people with H. pylori infection treated with 20 mg oral simvastatin twice a day for 1 week compared to placebo in a mid-sized RCT²⁷⁰Nseir W, Diab H et al. Randomised clinical trial: simvastatin as adjuvant therapy improves significantly the Helicobacter pylori eradication rate—a placebo-controlled study. Alimentary Pharmacology & Therapeutics. 2012 Aug;36(3):231-8.

Gynecologic cancer

Ovarian cancer is listed separately.

People treated with statins may have a slightly lower risk of gynecologic cancer as a whole.

People treated with statins for at least 6 months have shown a lower risk of cervical cancer.

Use of statins has not had an effect on risk of endometrial cancer recurrence, although some studies show a lower risk of endometrial cancer among people treated with statins. Women with type 2 diabetes treated with statins have shown lower risk of non-endometrioid endometrial cancer.

Gynecologic cancer as a whole: preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of slightly lower risk of gynecologic cancer as a whole among people treated with statins

30% lower gynecologic cancer mortality among people without cancer at baseline treated with statins for at least 6 months compared to no statins in a very large observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods study²⁷¹Kim DS, Ahn HS, Kim HJ. Statin use and incidence and mortality of breast and gynecology cancer: a cohort study using the National Health Insurance claims database. International Journal of Cancer. 2022 Apr 1;150(7):1156-1165.
11% lower risk of gynecologic cancer as a whole among people treated with statins compared to no statins in a very large meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 33 observational studies and 4 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects, although no evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. in a meta-analysis of RCTs alone²⁷²Chen Y, Han L, Zheng A. Association between statin use and the risk, prognosis of gynecologic cancer: a meta-analysis. European Journal of Obstetrics, Gynecology and Reproductive Biology. 2022 Jan;268:74-81.
A weak trendan apparent change due to a therapy, close to but not achieving full statistical significance (this is the CancerChoices definition; other researchers and studies may define this differently toward lower risk of gynecological cancer among people treated with statins compared to no statins in a large meta-analysis of 17 observational studies but no evidence of an effect on risk in a meta-analysis of 6 RCTs²⁷³Jeong GH, Lee KH et al. Effect of statin on cancer incidence: an umbrella systematic review and meta-analysis. Journal of Clinical Medicine. 2019 Jun 8;8(6):819.
A weak trend toward lower risk of gynecologic cancer among people treated with statins compared to no statins in a large meta-analysis of 4 RCTs and 10 observational studies²⁷⁴Liu Y, Qin A, Li T, Qin X, Li S. Effect of statin on risk of gynecologic cancers: a meta-analysis of observational studies and randomized controlled trials. Gynecologic Oncology. 2014 Jun;133(3):647-55.

Cervical cancer: good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) of slightly lower risk of cervical cancer among people treated with statins for at least 6 months

17% lower risk of cervical cancer among people treated with statins for at least 6 months compared to no statins in a very large observational study²⁷⁵Kim DS, Ahn HS, Kim HJ. Statin use and incidence and mortality of breast and gynecology cancer: a cohort study using the National Health Insurance claims database. International Journal of Cancer. 2022 Apr 1;150(7):1156-1165.

Endometrial cancer

Recurrence: no evidence of an effect on risk of recurrence among people with endometrial cancer treated with statins in a large study

No evidence of an effect on 5-year risk of recurrence among people with endometrial cancer treated with statins compared to no statins in a large observational study²⁷⁶Segev Y, Gemer O et al. An Israeli gynecologic oncology group study of statin use and endometrial cancer prognosis. International Journal of Gynaecology & Obstetrics. 2020 Jan;148(1):79-86.

Cancer risk

Preliminary and conflicting evidence of slightly lower risk of endometrial cancer among people treated with statins

19% lower risk of endometrial cancer (13 observational studies and 2 RCTs) and 29% lower mortality from endometrial cancer (11 observational studies) among people treated with statins compared to no statins in large meta-analyses, although no evidence of an effect in a meta-analysis of the RCTs alone²⁷⁷Chen Y, Han L, Zheng A. Association between statin use and the risk, prognosis of gynecologic cancer: a meta-analysis. European Journal of Obstetrics, Gynecology and Reproductive Biology. 2022 Jan;268:74-81.
No evidence of an effect on risk of endometrial cancer among people treated with statins compared to no statins in a large meta-analysis of 13 observational studies and 2 RCTs²⁷⁸Jeong GH, Lee KH et al. Effect of statin on cancer incidence: an umbrella systematic review and meta-analysis. Journal of Clinical Medicine. 2019 Jun 8;8(6):819.
Slightly lower risk of endometrial cancer among people treated with statins compared to no statins in a meta-analysis of 16 observational studies and RCTs, although no additional benefit among people using statins longer than 5 years in a meta-analysis of 5 observational studies and 1 RCT²⁷⁹Wang Y, Ren F et al. Statin use and the risk of ovarian and endometrial cancers: a meta-analysis. BMC Cancer. 2019 Jul 24;19(1):730.
A weak trend toward lower risk of endometrial cancer among people treated with statins compared to no statins in meta-analyses of 2 RCTs and 11 observational studies²⁸⁰Yang J, Zhu Q, Liu Q, Wang Y, Xie W, Hu L. Statin use and endometrial cancer risk: a meta-analysis. Oncotarget. 2017 Jun 27;8(37):62425-62434.
No evidence of an effect on risk of endometrial cancer among people treated with statins compared to no statins in a large meta-analysis of 4 RCTs and 10 observational studies²⁸¹Liu Y, Qin A, Li T, Qin X, Li S. Effect of statin on risk of gynecologic cancers: a meta-analysis of observational studies and randomized controlled trials. Gynecologic Oncology. 2014 Jun;133(3):647-55.

53% lower risk of non-endometrioid endometrial cancer among women with type 2 diabetes treated with statins compared to no statins in a very large observational study²⁸²Arima R, Marttila M et al. Antidiabetic medication, statins and the risk and prognosis of non-endometrioid endometrial cancer in women with type 2 diabetes. Anticancer Research. 2018 Jul;38(7):4169-4178.

Head and neck cancer

Statin use has not shown any effect on risk of recurrence among people with head and neck cancer.

Kidney cancer

Use of statins has shown no effect on risk of recurrence or incidence of kidney cancer.

No evidence of an effect on risk of recurrence (disease-free survival) among people with kidney cancer (renal cell carcinoma) treated with statins compared to no statins in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 7 observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods studies²⁸⁴Adli G, Yogiswara N, Gde Tirta Yoga Yatindra IB, Putra RM, Djatisoesanto W. Impact of statin on renal cell carcinoma patients undergoing nephrectomy. Does it affect cancer progression and improves survival? A systematic review and meta-analysis. Archivio Italiano de Urologia, Andrologia. 2023 Oct 4;95(3):11672.
No evidence of an effect on risk of recurrence among people with kidney cancer treated with statins compared to no statins in a meta-analysis of 4 observational studies²⁸⁵Nayan M, Punjani N et al. Statin use and kidney cancer survival outcomes: a systematic review and meta-analysis. Cancer Treatment Reviews. 2017 Jan;52:105-116.

Cancer risk: no evidence of an effect on risk of kidney cancer among people treated with statins

No evidence of an effect on risk of kidney cancer among people treated with statins compared to no statins in a large meta-analysis of 2 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects and 9 observational studies²⁸⁶Jeong GH, Lee KH et al. Effect of statin on cancer incidence: an umbrella systematic review and meta-analysis. Journal of Clinical Medicine. 2019 Jun 8;8(6):819.
No evidence of an effect on risk of kidney cancer among people treated with statins compared to no statins, including long-term use, in meta-analyses of 2 RCTs and 10 observational studies²⁸⁷Zhang XL, Liu M et al. Statin use and risk of kidney cancer: a meta-analysis of observational studies and randomized trials. British Journal of Clinical Pharmacology. 2014 Mar;77(3):458-65.

Lung cancer

People with lung cancer treated with statins show a slightly lower risk of recurrence, but statin use shows only weak and conflicting evidence of a lower risk of lung cancer.

Recurrence: good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) of a slightly lower risk of recurrence among people with lung cancer treated with statins

15% lower risk of recurrence among people with lung cancer treated with statins compared to no statins in a large meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 13 observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods studies²⁸⁸Chen Y, Li X et al. Effects of statin exposure and lung cancer survival: a meta-analysis of observational studies. Pharmacological Research. 2019 Mar;141:357-365.
No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on risk of recurrence after curative resection among people with non-small cell lung cancer treated with statins at least 1 month before surgery and continuing after the surgery compared to no statins in a mid-sized observational study²⁸⁹Oh TK, Kim K et al. Impact of statin use on recurrence or survival after surgical curative resection of non-small cell lung cancer. Cancer Control. 2018 Jan-Mar;25(1):1073274818778000.

Cancer risk: weakone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) and conflicting evidence of a lower risk of lung cancer among people treated with statins

13% lower risk of lung cancer among people treated with statins compared to no statins in a large meta-analysis of 24 observational studies but no evidence of an effect on risk in a meta-analysis of 9 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects²⁹⁰Jeong GH, Lee KH et al. Effect of statin on cancer incidence: an umbrella systematic review and meta-analysis. Journal of Clinical Medicine. 2019 Jun 8;8(6):819.
No evidence of an effect on risk of lung cancer among people treated with statins compared to no statins in a large meta-analysis of 5 RCTs and very large meta-analyses of 15 observational studies²⁹¹Wang J, Li C et al. Statin use and risk of lung cancer: a meta-analysis of observational studies and randomized controlled trials. PLoS One. 2013 Oct 25;8(10):e77950.
No evidence of an effect on risk of lung cancer among people treated with statins compared to no statins in a large meta-analysis of 5 RCTs and very large meta-analyses of 14 observational studies²⁹²Tan M, Song X et al. Statins and the risk of lung cancer: a meta-analysis. PLoS One. 2013;8(2):e57349.

Lymphoma

People treated with statins have slightly to moderately lower risk of diffuse large B-cell lymphoma or non-Hodgkin lymphoma, and a slightly lower risk of lymphoma as a whole.

Lymphoma as a whole: good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) of a slightly lower risk of lymphoma as a whole among people treated with statins

15% lower risk of lymphoma among people treated with statins compared to no statins in a large meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 16 observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods studies²⁹³Jeong GH, Lee KH et al. Effect of statin on cancer incidence: an umbrella systematic review and meta-analysis. Journal of Clinical Medicine. 2019 Jun 8;8(6):819.

Diffuse large B-cell lymphoma: good evidence of a moderately lower risk of diffuse large B-cell lymphoma among people treated with statins

30% lower risk of diffuse large B-cell lymphoma among people treated with statins compared to no statins in a very large meta-analysis of 6 observational studies²⁹⁴Ponvilawan B, Charoenngam N, Ungprasert P. Association between statin use & risk of diffuse large B-cell lymphoma: a systematic review & meta-analysis. Indian Journal of Medical Research. 2023 Jun;157(6):543-548.

Non-Hodgkin lymphoma: good evidence of a slightly to moderately lower risk of non-Hodgkin lymphoma among people treated with statins

18% lower risk of non-Hodgkin lymphoma among people treated with statins compared to no statins in a meta-analysis of 10 observational studies²⁹⁵Ye X, Mneina A, Johnston JB, Mahmud SM. Associations between statin use and non-Hodgkin lymphoma (NHL) risk and survival: a meta-analysis. Hematological Oncology. 2017 Jun;35(2):206-214.
19% lower risk of non-Hodgkin lymphoma among people treated with statins compared to no statins in a meta-analysis of 10 observational studies²⁹⁶Pradelli D, Soranna D et al. Statins use and the risk of all and subtype hematological malignancies: a meta-analysis of observational studies. Cancer Medicine. 2015 May;4(5):770-80.

Melanoma and other skin cancers

People treated with statins show a slightly lower risk of basal cell carcinoma but not other types of skin cancer.

Skin cancer as a whole: no evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on risk of skin cancer as a whole among people treated with hydrophilic statins

No evidence of an effect on risk of skin cancer as a whole among people treated with hydrophilic statins compared to no statins in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 10 observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods studies and 2 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects;²⁹⁷Wang D, Dai S et al. Association between statins exposure and risk of skin cancer: an updated meta-analysis. International Journal of Dermatology. 2023 Nov;62(11):1332-1344. also see evidence from this study that people treated with lipophilic statins had a higher risk of skin cancer in Safety and precautions ›

Melanoma: insufficient evidencepreclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example) (this is the CancerChoices definition; other researchers and studies may define this differently) of lower risk of melanoma among people treated with statins

A weak trendan apparent change due to a therapy, close to but not achieving full statistical significance (this is the CancerChoices definition; other researchers and studies may define this differently toward lower risk of melanoma among people treated with statins compared to no statins in a large meta-analysis of 11 observational studies but no evidence of an effect on risk in a meta-analysis of 13 RCTs²⁹⁸Jeong GH, Lee KH et al. Effect of statin on cancer incidence: an umbrella systematic review and meta-analysis. Journal of Clinical Medicine. 2019 Jun 8;8(6):819.
No evidence of an effect on risk of melanoma among people treated with statins compared to no statins in a very large meta-analysis of 7 observational studies and 17 post-hoc analyses or RCTs²⁹⁹Li X, Wu XB, Chen Q. Statin use is not associated with reduced risk of skin cancer: a meta-analysis. British Journal of Cancer. 2014 Feb 4;110(3):802-7.

Non-melanoma skin cancer: modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of a slightly lower risk of basal cell carcinoma but no evidence of lower risk of other non-melanoma skin cancer among people treated with statins

Slightly lower risk of basal cell carcinoma but no evidence of an effect on other types of skin cancer among people treated with hydrophilic statins compared to no statins in a meta-analysis of 10 observational studies and 2 RCTs;³⁰⁰Wang D, Dai S et al. Association between statins exposure and risk of skin cancer: an updated meta-analysis. International Journal of Dermatology. 2023 Nov;62(11):1332-1344. also see evidence from this study that people treated with lipophilic statins had a higher risk of skin cancer in Safety and precautions ›
No evidence of an effect on risk of non-melanoma skin cancer among people treated with statins compared to no statins in a very large meta-analysis of 2 observational studies and 12 post-hoc analyses or RCTs³⁰¹Li X, Wu XB, Chen Q. Statin use is not associated with reduced risk of skin cancer: a meta-analysis. British Journal of Cancer. 2014 Feb 4;110(3):802-7.

Ovarian cancer

People with type 2 diabetes and newly diagnosed ovarian cancer treated with statins showed substantially lower risk of recurrence in one small study. People treated with statins have shown lower risk of ovarian cancer or mortality from ovarian cancer, but the evidence is inconclusive.

Recurrence: preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of substantially lower risk of recurrence among people with type 2 diabetes and newly diagnosed ovarian cancer treated with statins

Substantially lower risk of recurrence at about 27 months among people with type 2 diabetes and newly diagnosed ovarian cancer treated with statins compared to no statins in a small observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods study³⁰²Amsler ME, Chmiel KA et al. Abstract LB-18: Statins use prevents ovarian cancer recurrence in women with diabetes mellitus. Cancer Research 2013 April 15;73(8_Supplement):LB–18.

Cancer risk: weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) of lower risk of ovarian cancer or mortality from ovarian cancer among people treated with statins

A weak trendan apparent change due to a therapy, close to but not achieving full statistical significance (this is the CancerChoices definition; other researchers and studies may define this differently toward lower risk of ovarian cancer (9 observational studies and 1 RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects) or mortality from ovarian cancer (12 observational studies) among people treated with statins compared to no statins in large meta-analysesstatistical analyses that combine the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study, although no evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. in the RCT alone³⁰³Chen Y, Han L, Zheng A. Association between statin use and the risk, prognosis of gynecologic cancer: a meta-analysis. European Journal of Obstetrics, Gynecology and Reproductive Biology. 2022 Jan;268:74-81.
A weak trend toward lower risk of ovarian cancer among people treated with statins compared to no statins in a very large meta-analysis of 10 observational studies³⁰⁴Mohammadian-Hafshejani A, Sherwin CMT, Heidari-Soureshjani S. Do statins play any role in reducing the incidence and mortality of ovarian cancer? A systematic review and meta-analysis. Journal of Preventive Medicine and Hygiene. 2020 Oct 6;61(3):E331-E339.
A weak trend toward lower risk of ovarian cancer among people treated with statins compared to no statins in a very large meta-analysis of 1 RCT and 8 observational studies³⁰⁵Irvin S, Clarke MA, Trabert B, Wentzensen N. Systematic review and meta-analysis of studies assessing the relationship between statin use and risk of ovarian cancer. Cancer Causes and Control. 2020 Oct;31(10):869-879.
No evidence of an effect on risk of ovarian cancer among people treated with statins compared to no statins in a meta-analysis of 10 observational studies and RCTs, although a weak trend toward lower risk among people using statins for more than 5 years in a meta-analysis of 5 observational studies³⁰⁶Wang Y, Ren F et al. Statin use and the risk of ovarian and endometrial cancers: a meta-analysis. BMC Cancer. 2019 Jul 24;19(1):730.
21% lower risk of ovarian cancer among people treated with statins compared to no statins in a large meta-analysis of 4 RCTs and 10 observational studies³⁰⁷Liu Y, Qin A, Li T, Qin X, Li S. Effect of statin on risk of gynecologic cancers: a meta-analysis of observational studies and randomized controlled trials. Gynecologic Oncology. 2014 Jun;133(3):647-55.

Pancreatic cancer

Some studies have found that people treated with statins have a lower risk of pancreatic cancer, but the evidence is conflicting and inconclusive.

Preliminarysignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) and somewhat conflicting evidence of lower risk of pancreatic cancer among people treated with statins

17% lower risk of pancreatic cancer among people treated with statins compared to no statins in a very large meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 23 observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods studies but no evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. in a meta-analysis of 3 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects³⁰⁸Karbowska E, Swieczkowski D et al. Statins and the risk of pancreatic cancer: a systematic review and meta-analysis of 2,797,186 patients. Cardiology Journal. 2024;31(2):243-250.
No evidence of an effect on risk of pancreatic cancer among people treated with statins compared to no statins in a large meta-analysis of 3 RCTs and 17 observational studies³⁰⁹Jeong GH, Lee KH et al. Effect of statin on cancer incidence: an umbrella systematic review and meta-analysis. Journal of Clinical Medicine. 2019 Jun 8;8(6):819.
30% lower risk of pancreatic cancer among people treated with statins compared to no statins, with stronger effects among males and from atorvastatin, in a very large meta-analysis of 22 observational studies and 5 RCTs³¹⁰Archibugi L, Arcidiacono PG, Capurso G. Statin use is associated to a reduced risk of pancreatic cancer: a meta-analysis. Digestive and Liver Disease. 2019 Jan;51(1):28-37.
16% lower risk of pancreatic cancer among people treated with statins compared to no statins in a very large meta-analysis of 26 observational studies but no evidence of an effect on risk in a meta-analysis of 3 RCTs³¹¹Zhang Y, Liang M et al. Statin use and risk of pancreatic cancer: an updated meta-analysis of 26 studies. Pancreas. 2019 Feb;48(2):142-150.
No evidence of an effect on risk of pancreatic cancer among people treated with statins compared to no statins in a very large meta-analysis of 16 clinical studies³¹²Cui X, Xie Y et al. Statin use and risk of pancreatic cancer: a meta-analysis. Cancer Causes and Control. 2012 Jul;23(7):1099-111.

Prostate cancer

People with prostate cancer treated with statins after radiotherapy show moderately lower risk of biochemical recurrence, but not after radical prostatectomy. Statin use leads to slightly to moderately lower risk of advanced prostate cancer, although an effect on early stage or localized cancer hasn’t been established.

Recurrence

After radical prostatectomy alone or considering any type of treatment as a whole: insufficient evidencepreclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example) (this is the CancerChoices definition; other researchers and studies may define this differently) of lower risk of biochemical recurrence, although stronger effects among high-risk patients, among people with prostate cancer treated with statins

A weak trendan apparent change due to a therapy, close to but not achieving full statistical significance (this is the CancerChoices definition; other researchers and studies may define this differently toward lower risk of biochemical recurrence after curative radical prostatectomy or radiotherapy among people with prostate cancer treated with statins, with stronger effects among high-risk patients, compared to no statins, although starting statin use after curative treatment did not reduce risk, in a very large meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 27 observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods studies³¹³Yin P, Han S, Hu Q, Tong S. The association of statin use and biochemical recurrence after curative treatment for prostate cancer: a systematic review and meta-analysis. Medicine (Baltimore). 2022 Jan 7;101(1):e28513.
No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on 1-year or 2-year biochemical recurrence rates after radical prostatectomy among people with pathologic high-risk prostate cancer treated with 20 mg atorvastatin per day for 1 year compared to placeboa pill, medicine, or procedure—thought to be both harmless and ineffective—prescribed for the psychological benefit to the patient or as a sham treatment in a study to allow a comparison to a therapy of interest in a mid-sized RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects³¹⁴Jeong IG, Lim B et al. Adjuvant low-dose statin use after radical prostatectomy: the PRO-STAT randomized clinical trial. Clinical Cancer Research. 2021 Sep 15;27(18):5004-5011.
No evidence of an effect on biochemical recurrence after radical prostatectomy among people with prostate cancer treated with statins compared to no statins in a meta-analysis of 15 observational studies³¹⁵Raval AD, Thakker D et al. Association between statins and clinical outcomes among men with prostate cancer: a systematic review and meta-analysis. Prostate Cancer and Prostatic Diseases. 2016 Jun;19(2):151-62.
No evidence of an effect on risk after radical prostatectomy among people with prostate cancer treated with statins compared to no statins in a meta-analysis of 13 observational studies³¹⁶Luo Y, She DL, Xiong H, Fu SJ, Yang L. The prognostic effect of statin use on urologic cancers: an updated meta-analysis of 35 observational studies. Medicine (Baltimore). 2015 Sep;94(36):e1523.
No evidence of an effect on risk of biochemical recurrence after curative radical prostatectomy or radiotherapy among people with prostate cancer treated with statins compared to no statins in a meta-analysis of 8 observational studies³¹⁷Scosyrev E, Tobis S et al. Statin use and the risk of biochemical recurrence of prostate cancer after definitive local therapy: a meta-analysis of eight cohort studies. BJU International. 2013 Mar;111(3 Pt B):E71-7.
No evidence of an effect on risk of recurrence after radical prostatectomy among people with prostate cancer treated with statins compared to no statins in a large meta-analysis of 7 observational studies³¹⁸Park HS, Schoenfeld JD et al. Statins and prostate cancer recurrence following radical prostatectomy or radiotherapy: a systematic review and meta-analysis. Annals of Oncology. 2013 Jun;24(6):1427-34.

After radiotherapy alone: good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) of moderately lower risk of biochemical recurrence after radiation therapy among people with prostate cancer treated with statins

21% lower risk of biochemical recurrence after radiation therapy among people with prostate cancer treated with statins compared to no statins in a meta-analysis of 10 observational studies³¹⁹Raval AD, Thakker D et al. Association between statins and clinical outcomes among men with prostate cancer: a systematic review and meta-analysis. Prostate Cancer and Prostatic Diseases. 2016 Jun;19(2):151-62.
32% lower risk of biochemical recurrence after radiotherapy among people with prostate cancer treated with statins compared to no statins in a meta-analysis of 7 observational studies³²⁰Luo Y, She DL, Xiong H, Fu SJ, Yang L. The prognostic effect of statin use on urologic cancers: an updated meta-analysis of 35 observational studies. Medicine (Baltimore). 2015 Sep;94(36):e1523.
32% lower risk of recurrence after radiotherapy among people with prostate cancer treated with statins compared to no statins in a large meta-analysis of 6 observational studies³²¹Park HS, Schoenfeld JD et al. Statins and prostate cancer recurrence following radical prostatectomy or radiotherapy: a systematic review and meta-analysis. Annals of Oncology. 2013 Jun;24(6):1427-34.

Cancer risk

Advanced cancer or cancer mortality: good evidence of slightly to moderately lower risk of advanced prostate cancer among people treated with statins

19% lower risk of advanced prostate cancer among people treated with statins compared to no statins in a very large meta-analysis of 14 observational studies³²²Li Y, Cheng X et al. Effect of statins on the risk of different stages of prostate cancer: a meta-analysis. Urologia Internationalis. 2022;106(9):869-877.

Localized cancer or prostate cancer as a whole: weakone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) and conflicting evidence of a slightly lower risk of prostate cancer among people treated with statins

No evidence of an effect on risk of localized prostate cancer among people treated with statins compared to no statins in a very large meta-analysis of 14 observational studies³²³Li Y, Cheng X et al. Effect of statins on the risk of different stages of prostate cancer: a meta-analysis. Urologia Internationalis. 2022;106(9):869-877.
Slightly lower risk of prostate cancer among people treated with lipophilic statins and a weak trend toward lower risk among people using hydrophilic statins compared to no statins in a meta-analysis of 14 observational studies³²⁴Cao Z, Yao J et al. Association between statin exposure and incidence and prognosis of prostate cancer: a meta-analysis based on observational studies. American Journal of Clinical Oncology. 2023 Jul 1;46(7):323-334.
Slightly lower risk of prostate cancer among people treated with statins compared to no statins in a large meta-analysis of 57 observational studies but no evidence of an effect on risk in a meta-analysis of 7 RCTs³²⁵Jeong GH, Lee KH et al. Effect of statin on cancer incidence: an umbrella systematic review and meta-analysis. Journal of Clinical Medicine. 2019 Jun 8;8(6):819.
No evidence of an effect on risk of prostate cancer among people treated with either hydrophilic or lipophilic statins compared to no statins in a very large meta-analysis of 7 observational studies and 3 RCTs³²⁶Tan P, Zhang C et al. Effect of statins type on incident prostate cancer risk: a meta-analysis and systematic review. Asian Journal of Andrology. 2017 Nov-Dec;19(6):666-671.
A weak trend toward lower risk of prostate cancer among people treated with statins compared to no statins in a very large meta-analysis of 36 observational studies, but no evidence of an effect in a meta-analysis of 6 RCTs³²⁷Tan P, Wei S et al. LDL-lowering therapy and the risk of prostate cancer: a meta-analysis of 6 randomized controlled trials and 36 observational studies. Scientific Reports. 2016 Apr 14;6:24521.

Sarcoma

Postmenopausal women treated with statins show lower bone/connective tissue cancer mortality.

Statins combined with other therapies

People treated with both statins and aspirin show substantially lower risk of gallbladder cancer and moderately lower risk of Barrett’s esophagus—a risk factor for esophageal cancer.

Diabetic people treated with both statins and metformin may possibly have a lower risk of high-grade cancer and a weak trend toward less stage pT3 or higher prostate cancer.

Statins and aspirin

Substantially lower risk of gallbladder cancer among people treated with aspirin and statins compared to neither in a large observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods study³²⁹Prasai K, Tella SH et al. Aspirin and statin use and the risk of gallbladder cancer. Cancers (Basel). 2021 Mar 9;13(5):1186.

Modest evidence of moderately lower risk of Barrett’s esophagus—a risk factor for esophageal cancer—after first gastroscopy among males treated with statins and aspirin

Moderately lower risk of Barrett’s esophagus after first gastroscopy among males treated with statins and aspirin, and stronger effects with longer treatment duration, in a combined analysis of 4 observational studies³³⁰Beales IL, Dearman L, Vardi I, Loke Y. Reduced risk of Barrett’s esophagus in statin users: case-control study and meta-analysis. Digestive Diseases and Sciences. 2016 Jan;61(1):238-46.

Statins and metformin: preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of lower risk of high-grade cancer and a weak trendan apparent change due to a therapy, close to but not achieving full statistical significance (this is the CancerChoices definition; other researchers and studies may define this differently toward less stage pT3 or higher prostate cancer among diabetic people treated with both statins and metformin

Lower risk of high-grade (Gleason sum of 8-10) cancer and a weak trend toward less stage pT3 or higher prostate cancer among diabetic people treated with both statins and metformin compared to neither or to single use of either metformin or statins in a mid-size observational study³³¹Danzig MR, Kotamarti S, Ghandour RA et al. Synergism between metformin and statins in modifying the risk of biochemical recurrence following radical prostatectomy in men with diabetes. Prostate Cancer and Prostatic Diseases. 2015 Mar;18(1):63-8.

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Last update: January 21, 2025

Last full literature review: April 2024

CancerChoices provides information about integrative in cancer care, a patient-centered approach combining the best of conventional care, self care and evidence-informed complementary care in an integrated plan cancer care. We review complementaryin cancer care, complementary care involves the use of therapies intended to enhance or add to standard conventional treatments; examples include supplements, mind-body approaches such as yoga or psychosocial therapy, and acupuncture therapies and self-care lifestyle actions and behaviors that may impact cancer outcomes; examples include eating health-promoting foods, limiting alcohol, increasing physical activity, and managing stress practices to help patients and professionals explore and integrate the best combination of conventionalthe cancer care offered by conventionally trained physicians and most hospitals; examples are chemotherapy, surgery, and radiotherapy and complementary therapies and practices for each person.

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References[+]

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