Ezetimibe Treatment Is Associated with Lower Risk of Incident Cancer: A Nationwide Population-Based Cohort Study

Ezetimibe has demonstrated favorable outcomes, including a reduction in cardiovascular complications and improvement in insulin resistance. However, its association with cancer risk remains unclear. This study evaluated the association between the use of ezetimibe-statin combination therapy and cancer risk using real-world data.

Korean National Health Insurance Service database health records were analyzed using propensity score matching to compare the cancer-related outcomes between ezetimibe-statin combination therapy and statin monotherapy groups. Outcomes included cancer incidence, cancer-specific mortality, and all-cause mortality.

In a cohort of 669,036 statin users, ezetimibe-statin combination therapy was associated with a significantly lower risk of cancer (hazard ratio [HR], 0.89; P<0.001) and cancer-related mortality (HR, 0.85; P<0.001) compared with statin monotherapy. Combination therapy was also associated with a lower risk of specific cancers, including colorectal, liver, breast, pancreatic, and biliary tract cancers. These inverse associations were consistent across subgroups stratified according to age, sex, alcohol consumption/smoking history, and the presence of diabetes or hypertension (all P for interaction >0.05). Moreover, a longer duration of ezetimibe use was linked to a lower cancer risk, with the most pronounced inverse associations observed in individuals who had used the drug for ≥4 years.

These findings suggest that ezetimibe combined with statins may be associated with a reduced risk of cancer.