Metabolic & Cardiometabolic
ezetimibe decreases cancer risk
Part of: 💊 ezetimibe
📅 Last reviewed: 2026-07-15 ⓘ
Evidence ladder
How far up the ladder this claim has climbed. A high consensus on a low rung means "consistent so far," not "proven in people."
Top evidence so far: All trials, pooled (Meta-analysis)
How the studies fall
What the evidence shows
The idea that ezetimibe lowers cancer risk is refuted by randomised data showing it is cancer-neutral. In IMPROVE-IT the malignancy HR was 1.03 (0.93-1.14). The Peto/CTSU analysis of SHARP plus IMPROVE-IT found no overall cancer difference (RR 0.96), which also answered the earlier SEAS signal. A BMJ harms meta-analysis of 48 RCTs gave cancer RR 1.01 (0.92-1.11).
The evidence (4)
| Source | Grade | Stance | Quality | Finding |
|---|---|---|---|---|
| Giugliano RP, Gencer B, Wiviott SD, Park JG, Fuchs CS, Goessling W, Musliner TA, Tershakovec AM, Blazing MA, Califf R, Cannon CP, Braunwald E 2020 · JACC CardioOncol | RCT | contradicts | high | FT IMPROVE-IT malignancy HR 1.03 (0.93-1.14); cancer-NEUTRAL not protective |
| Wang Y, Zhan S, Du H, Li J, Khan SU, Aertgeerts B, Guyatt G, Hao Q, Bekkering G, Li L, Delvaux N, Su N, Riaz I, Vandvik PO, Tian H, Li S 2022 · BMJ Med | meta-analysis | contradicts | high | [FT-verified] BMJ Rapid Recommendations harms SR/MA: 48 RCTs, 28,444 participants overall (median follow-up 34 weeks; number of trials reporting cancer shown only in figure 3 - cannot-tell from text). Cancer (any type): RR 1.01 (95% CI 0.92 to 1.11), moderate-to-high certainty; >=48-week trials RR 1.01 (0.92 to 1.11), <48-week 0.79 (0.21 to 3.01), interaction P=0.72. A precise clean null centred on no effect - contradicts 'ezetimibe decreases cancer risk'. PROSPERO CRD42020187437; academic funding. |
| Peto R, Emberson J, Landray M, Baigent C, Collins R, Clare R, Califf R 2008 · N Engl J Med | meta-analysis | contradicts | high | Peto/CTSU cancer analysis of three ezetimibe+simvastatin trials. Hypothesis-testing pool is SHARP (9264, 2.7 y) + IMPROVE-IT interim (11,353, 1.0 y) only: 'no overall excess of cancer (313 active-treatment vs. 326 control; risk ratio, 0.96; 95% confidence interval, 0.82 to 1.12; P=0.61)'. SEAS (1873) separately showed more cancer (101 vs 65). A null on this directional claim, so contradicts. Combination exposure in SEAS/SHARP; short follow-up. |
| Lim Y, Kim E, Hwang E, Kim K, Son Y, Lee SY, Cho YH, Park EJ, Lee Y, Lee SR, Choi JI, Jeong HS, Park SJ, Son SM, Kwon RJ 2025 · J Cancer Res Clin Oncol | observational | supports | low | FT only 383 ezetimibe users; aHR 0.30->0.70 implausible residual-confounding; cannot support causal cancer reduction |
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