The impact of angiotensin-converting enzyme inhibitors on lung cancer
and non-lung cancers compared with angiotensin II receptor blockers
Aim: Angiotensin-converting enzyme inhibitors (ACEIs)
and angiotensin II receptor blockers (ARBs) have been reported to
manifest controversial relationships with cancer, and recent focus
concerning the tumorigenic effect of ACEIs mainly falls on lung cancer.
We compared ACEIs with ARBs for their impact on the risk and prognosis
of lung cancer and non-lung cancers, respectively.
Methods: A meta-analysis was performed to explore the
impact of ACEIs on the risk of lung cancer and non-lung cancers, while a
systematic review was performed to further analyze ACEIs’ influence on
the prognosis of lung cancer. Terms concerning ACEIs and cancer were
searched, and 10 cohort studies were included for risk analysis, while 5
cohort studies were included for analyzing the prognosis of lung cancer.
Results: Initial pooled result revealed that ACEIs
prescription is associated with an observed increase on the risk of lung
cancer (RR 1.28, 95% CI 1.02-1.61), colorectal cancer (RR 1.46, 95% CI
1.13-1.87) and hepatic cancer (RR 2.00, 95% CI 1.01-3.94) when compared
with ARBs, but further sensitivity analyses suggested the results
unsolid, thus neither the development of lung cancer nor non-lung
cancers could be proved associated with ACEIs prescription. However,
systematic review suggested that ACEIs prescription is associated with
an improved lung cancer prognosis. Conclusion: There has
been no adequate evidence to demonstrate that ACEIs are associated with
a higher incidence of lung cancer or non-lung cancers, but an improved
prognosis of lung cancer was observed in patients taking ACEIs.
Large-scale RCTs are needed and underlying mechanisms need further