Statins
Also called: atorvastatin, simvastatin, HMG-CoA reductase inhibitors.
Last reviewed 2026-09-16. How this works.
Treating cancer Grade D
No human evidence of benefit, or none that survived testing.
Studies of people taking statins looked promising, and when trials tested it properly nothing was there.
Pooled randomised trials give a hazard ratio of 0.94, with an interval crossing one.
The claim
The claim is that statins, taken by a very large share of adults already, also treat cancer. The observational evidence behind it is enormous.
What it does
Statins block an enzyme in cholesterol synthesis, and that pathway feeds several processes cancer cells use. The mechanism is not the problem with this entry.
The evidence
The observational case is genuinely impressive. In the entire Danish population diagnosed with cancer over twelve years, 18,721 statin users before diagnosis were compared with 277,204 never-users, and the adjusted hazard ratio was 0.85 for death from any cause and 0.85 for death from cancer.2
Then the randomised trials. Pooling ten of them across 1,881 people with active cancer and 1,572 deaths, adding a statin to standard treatment gave a hazard ratio for overall survival of 0.94, with a confidence interval from 0.85 to 1.04. Progression-free survival was 0.97. Both intervals cross one.1
This chapter is the clearest worked example in the book of why that happens, and the sharpest piece of evidence is Finnish. Among 16,924 men followed for a median of nineteen years, statin use was associated with lower cancer mortality, hazard ratio 0.87. Adjust for cholesterol level and the association disappears: hazard ratio 1.08, interval crossing one. Same data, same people, one variable added.4
Published correspondence against the Danish paper makes the same point formally, one letter presenting a causal diagram of biased association owing to survivor selection. And a meta-analysis of individual data from 175,000 people in 27 randomised statin trials found no effect of lowering cholesterol on cancer.35
The authors of the pooled analysis leave one question open: whether people with a better prognosis, treated for longer, might benefit. Their trials were in advanced cancer with a prognosis under two years.1
The studies this rests on
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Pooled randomised trials of statins added to standard cancer therapy1
A meta-analysis, summarising randomised trials, measured survival, 1881 participants.
no improvement in overall or progression-free survival.
hazard ratio 0.94, interval 0.85 to 1.04. overall survival; progression-free survival 0.97, interval 0.87 to 1.07
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Danish nationwide cohort of statin use before cancer diagnosis23
An observational study, measured survival, 295925 participants.
lower all-cause and cancer mortality among statin users; subject to published correspondence on survivor selection.
hazard ratio 0.85, interval 0.83 to 0.87. death from any cause
What is absent
No randomised trial has tested statins in people with a longer prognosis, treated for longer. The pooled trials were in advanced cancer, and their authors name this as the remaining question.
Scope: people with cancer and a prognosis beyond two years.
Established by published review, PLOS One 2018;13(12):e0209486, checked 2026-09-16. Result: the authors conclude future research should assess whether patients with better prognosis benefit from longer-term statin therapy.1
What to ask
If I am already on a statin for my heart, does that change anything about my cancer treatment?
The dish-to-person gap
The register holds no human pharmacokinetic measurement for statins against a laboratory concentration. This entry rests on randomised outcome data.
When to call your team — no warning signs are recorded
Whatever you are taking or thinking of taking, the people treating you can only weigh it if they know about it. That is true when nothing has been written down here, and it is most true then.
The register records no warning signs for statins. That is not a statement that nothing can go wrong, and anyone taking a prescription drug outside its licence should tell their oncology team.
Interactions
The register holds no measured interaction between statins and a cancer treatment class.
Nobody having looked is not the same as nothing being there. That is what this line says and all it says.
The whole interaction list, and how to turn it into a pharmacy review request.
Find a trial instead
The pooled analysis suggests the open question is whether people with a longer prognosis benefit, which is a trial question.
Search ClinicalTrials.gov for recruiting studies of statin OR simvastatin OR atorvastatin
A trial is the same decision with monitoring, a known preparation and a doctor who knows what else you are taking.
References
Statin therapy in the treatment of active cancer: a systematic review and meta-analysis of randomized controlled trials. PLOS One 2018;13(12):e0209486. PROSPERO CRD42017065503.
doi:10.1371/journal.pone.0209486
How this was reached: transcribed from chapter note, via docs/CHAPTER-NOTES.json, chapter 14 note 8.
Nielsen SF, Nordestgaard BG, Bojesen SE. Statin use and reduced cancer-related mortality. New England Journal of Medicine 2012;367(19):1792-1802.
doi:10.1056/NEJMoa1201735 · PubMed 23134381
How this was reached: transcribed from chapter note, via docs/CHAPTER-NOTES.json, chapter 14 note 5.
Correspondence, New England Journal of Medicine 2013;368(6):574-577, comprising letters from Klop C, Driessen JH and de Vries F; Dawwas MF; and Kopel E, Maor E and Goldenberg I, with a reply from the original authors.
doi:10.1056/NEJMc1214827 · PubMed 23388013
How this was reached: transcribed from chapter note, via docs/CHAPTER-NOTES.json, chapter 14 note 6.
Inverse association between statin use and cancer mortality relates to cholesterol level. A study of 16,924 men in the Finnish Randomized Study of Screening for Prostate Cancer.
No persistent identifier recorded.
How this was reached: transcribed from chapter note, via docs/CHAPTER-NOTES.json, chapter 14 note 7.
Emberson JR, Kearney PM, Blackwell L, 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:e29849.
No persistent identifier recorded.
How this was reached: transcribed from chapter note, via docs/CHAPTER-NOTES.json, chapter 14 note 9. The author string is abbreviated in the source that was read and has not been expanded.