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Is angiotensin-converting enzyme inhibitors/angiotensin receptor blockers therapy protective against prostate cancer?
Yeqing Mao1, Xin Xu1, Xiao Wang1
1Department of Urology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Abstract:
Emerging evidence suggests that renin-angiotensin system (RAS) may act as a molecular and therapeutic target for treating site-specific cancers, including prostate cancer. However, previous observational studies regarding the association between RAS inhibitors and prostate cancer risk have reported inconsistent results. We examined this association by performing a systematic review and meta-analysis. A total of 20,267 patients from nine cohort studies were enrolled. Compared with non-users of RAS inhibitors, individuals using RAS inhibitors had a reduced risk of prostate cancer (RR 0.92, 95 % CI 0.87-0.98), without statistically significant heterogeneity among studies (P = 0.118 for heterogeneity, I2 = 37.6 %). In addition, when subgroup analyses by study quality and number of cases, more statistically significant associations were observed in studies of high quality (RR 0.93, 95 % CI 0.88-0.97) and large sample size (RR 0.94, 95 % CI 0.91-0.98). There was no evidence of significant publication bias with Begg's test (P = 0.602) or with Egger's test (P = 0.350). Overall, this study indicates that use of RAS inhibitors may be associated with a decreased risk of prostate cancer. Large-scale well designed studies are needed to further explore this association.
Insights
RAS inhibitors may lower prostate cancer risk. This meta-analysis of nine cohort studies found a reduced risk of prostate cancer in patients using RAS inhibitors, suggesting a potential therapeutic target.
Area of Science:
- Oncology
- Pharmacology
- Epidemiology
Background:
- The renin-angiotensin system (RAS) is implicated as a potential therapeutic target for various cancers, including prostate cancer.
- Previous observational studies on RAS inhibitors and prostate cancer risk have yielded conflicting results.
Purpose of the Study:
- To systematically review and meta-analyze existing cohort studies to clarify the association between RAS inhibitor use and prostate cancer risk.
Main Methods:
- A systematic review and meta-analysis were conducted.
- Data from nine cohort studies, encompassing 20,267 patients, were analyzed.
- Subgroup analyses were performed based on study quality and sample size.
Main Results:
- RAS inhibitor use was associated with a reduced risk of prostate cancer (RR 0.92, 95% CI 0.87-0.98).
- The association remained significant in high-quality studies and studies with larger sample sizes.
- No significant heterogeneity or publication bias was detected.
Conclusions:
- The use of RAS inhibitors may be linked to a decreased risk of developing prostate cancer.
- Further large-scale, well-designed studies are warranted to confirm this association and explore underlying mechanisms.
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