Statin use and colorectal cancer prognosis: an updated systematic review and meta-analysis
Abstract
PurposeStatins are affordable and commonly prescribed, but their impact on mortality in patients with colorectal cancer (CRC) remains unclear.MethodsA systematic search of PubMed, Embase, and the Cochrane Library identified English-language studies on statin use and CRC mortality published through March 2025. Adjusted hazard ratios (HRs) with 95% confidence intervals (95% CIs) were pooled to calculate summary HRs. Heterogeneity was assessed using the Q-test and I2 statistic, applying fixed-effects models for I2 <50% and random-effects models for I2 ≥50%. Subgroup analyses explored sources of heterogeneity.ResultsTwenty studies involving 207, 041 patients with CRC were included. Ten studies (131, 599 patients) evaluated prediagnostic statin use, and 13 studies (75, 442 patients) evaluated postdiagnostic statin use. For prediagnostic use, fixed-effects models yielded pooled HRs of 0.87 (95% CI, 0.81–0.92) for all-cause mortality (ACM) and 0.82 (95% CI, 0.78–0.86) for cancer-specific mortality (CSM). For postdiagnostic use, random-effects models showed pooled HRs of 0.81 (95% CI, 0.73–0.89) for ACM and 0.76 (95% CI, 0.69–0.84) for CSM. Subgroup analyses revealed significant differences in ACM by region, tumor location, and follow-up duration with notable findings in European patients. A statistically significant difference was observed between studies with ≥5 years of follow-up and between stage I–III patients. Sensitivity analyses restricted to studies using time-dependent Cox regression produced consistent estimates for both cancer-specific and all-cause mortality.ConclusionPrediagnostic and postdiagnostic statin use were associated with reduced ACM and CSM in patients with CRC. However, given the observational nature of the included studies and the potential for residual confounding, these findings should be interpreted as associations rather than causal effects, and they require confirmation in large-scale, prospective randomized trials.
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BibTeX
@article{jiang2026statin,
title = {{Statin use and colorectal cancer prognosis: an updated systematic review and meta-analysis}},
author = {Tao Jiang and Jiaxin Wu and Lichao Fan and Wenjiang Wu and Xuesong Tang and Zhigang Xu and Linchong Yu and Shijun Xia},
journal = {Frontiers in Oncology},
year = {2026},
month = nov,
doi = {10.3389/fonc.2026.1920835},
url = {https://www.frontiersin.org/articles/10.3389/fonc.2026.1920835},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Statin use and colorectal cancer prognosis: an updated systematic review and meta-analysis
AU - Tao Jiang
AU - Jiaxin Wu
AU - Lichao Fan
AU - Wenjiang Wu
AU - Xuesong Tang
AU - Zhigang Xu
AU - Linchong Yu
AU - Shijun Xia
PY - 2026
DA - 2026/11/09
JO - Frontiers in Oncology
DO - 10.3389/fonc.2026.1920835
UR - https://www.frontiersin.org/articles/10.3389/fonc.2026.1920835
AB - PurposeStatins are affordable and commonly prescribed, but their impact on mortality in patients with colorectal cancer (CRC) remains unclear.MethodsA systematic search of PubMed, Embase, and the Cochrane Library identified English-language studies on statin use and CRC mortality published through March 2025. Adjusted hazard ratios (HRs) with 95% confidence intervals (95% CIs) were pooled to calculate summary HRs. Heterogeneity was assessed using the Q-test and I2 statistic, applying fixed-effects models for I2 <50% and random-effects models for I2 ≥50%. Subgroup analyses explored sources of heterogeneity.ResultsTwenty studies involving 207, 041 patients with CRC were included. Ten studies (131, 599 patients) evaluated prediagnostic statin use, and 13 studies (75, 442 patients) evaluated postdiagnostic statin use. For prediagnostic use, fixed-effects models yielded pooled HRs of 0.87 (95% CI, 0.81–0.92) for all-cause mortality (ACM) and 0.82 (95% CI, 0.78–0.86) for cancer-specific mortality (CSM). For postdiagnostic use, random-effects models showed pooled HRs of 0.81 (95% CI, 0.73–0.89) for ACM and 0.76 (95% CI, 0.69–0.84) for CSM. Subgroup analyses revealed significant differences in ACM by region, tumor location, and follow-up duration with notable findings in European patients. A statistically significant difference was observed between studies with ≥5 years of follow-up and between stage I–III patients. Sensitivity analyses restricted to studies using time-dependent Cox regression produced consistent estimates for both cancer-specific and all-cause mortality.ConclusionPrediagnostic and postdiagnostic statin use were associated with reduced ACM and CSM in patients with CRC. However, given the observational nature of the included studies and the potential for residual confounding, these findings should be interpreted as associations rather than causal effects, and they require confirmation in large-scale, prospective randomized trials.
SN - 2234-943X
ER -