Drugs affecting renin-angiotensin-aldosterone system and the cancer risk: A meta-analysis of nested case-control studies.

Multiple studies have discussed the associations between drugs affecting the renin-angiotensin-aldosterone system and the cancer risk, but their consequence s were conflicting. A meta-analysis of nested case-control studies published regarding this subject was conducted in our study, aims to estimate the association between ACEI/ARB and the cancer risk. Pubmed database was searched up to February, 1 2016 to identify eligible nested case-control studies, and we used Newcastle-Ottawa Scale (NOS) to assess quality of the studies. Pooled odds ratio (OR) and 95% confidence intervals (CIs) were calculated (with fixed effect model: Mantel-Haenszel). Publication bias and heterogeneity were evaluated before the calculation. Subgroup analysis and sensitivity analysis were also performed. Seven studies contributed to the analysis. Overall, ACEI/ARB use was not associated with the risk of cancer (OR=0.99, 95% CI 0.97-1.01), nor in long-term use patients (OR=0.97, 95% CI 0.92-1.01). ACEI may decrease cancer risk (OR=0.90, 95% CI 0.82-0.99). We observed no significant publication bias. In conclusion, ACEI/ARB use was not associated with cancer risk, nor in long-term use patients, but ACEI use may decrease cancer risk. More researches are needed to confirm these findings.