Should I take statins? Statins can reduce your risk of heart disease and cancer

Ruslan Dorfman, PhD, MBA16 Oct 2026

Many people do not like taking statins because of side effects, yet statins are among the most effective medications for preventing heart attacks, strokes and early death. Some studies also suggest that statins may lower the risk of cancer or of dying from it. Knowing your genetic profile can help choose the right statin and dose, so you can stay on treatment with fewer side effects.

Who should take a statin?

Statins lower "bad" LDL cholesterol by blocking HMG-CoA reductase, the enzyme the liver uses to make cholesterol. According to the 2021 Canadian Cardiovascular Society guidelines, statins are recommended for most people who have had a heart attack, stroke or other artery disease, most people with diabetes or chronic kidney disease, people with very high LDL cholesterol, and others whose overall risk of heart disease is high. Lowering cholesterol earlier in life may also protect the brain: the 2024 Lancet Commission on dementia added high LDL cholesterol in midlife to its list of modifiable risk factors for dementia and recommends detecting and treating high LDL cholesterol from about age 40. The statins available in Canada are:

Atorvastatin (Lipitor)
Rosuvastatin (Crestor)
Simvastatin (Zocor)
Pravastatin
Lovastatin
Fluvastatin (Lescol)
Pitavastatin (Livalo)

Statins also help older adults: in a large study of US veterans aged 75 and older, statin use was linked with lower overall and cardiovascular death rates.

What other medications lower cholesterol?

When a statin is not enough or not tolerated, the 2021 Canadian guidelines list other options:

Ezetimibe, a tablet that reduces cholesterol absorption from food, usually the first add-on.
PCSK9 inhibitors, alirocumab (Praluent) and evolocumab (Repatha), injections that help the liver remove more LDL from the blood. They lower LDL the most and are used for people with familial hypercholesterolemia, people at very high risk, and people who cannot take statins.
Bempedoic acid (Nexletol), a tablet that works in the liver and rarely causes muscle symptoms.
Inclisiran (Leqvio), an injection given twice a year after the first doses.

Fibrates (fenofibrate, gemfibrozil) mainly lower triglycerides. Niacin is no longer recommended because it did not prevent heart attacks or strokes in trials and has frequent side effects.

Do diet and cholesterol affect cancer risk?

A diet high in red and processed meat is linked with a higher risk of colorectal cancer, and limiting processed foods high in saturated and trans fats is good for both heart health and overall health. Statins are needed when cholesterol stays high despite a healthy diet or when heart disease risk is high for other reasons.

Do statins reduce cancer risk?

The evidence is promising but not conclusive:

Population studies. In a study of the entire Danish population, people who were already taking statins when they were diagnosed with cancer were about 15% less likely to die from their cancer than people who never took statins. This lower risk was seen for 13 cancer types. Such studies show an association, not cause and effect.
Genetic studies. A study of 367,703 people in the UK Biobank used gene variants as natural "experiments". People with variants in the HMGCR gene, which mimic the effect of a statin, had a lower overall risk of cancer. Variants that mimic other cholesterol drugs (in the PCSK9, NPC1L1 and other genes) were not linked to cancer risk, and LDL cholesterol level itself was not linked to cancer. The authors concluded that statins may lower cancer risk through a pathway that does not depend on cholesterol, possibly by reducing inflammation or cell growth.
Randomized trials. An analysis of 27 statin trials with 175,000 people found that about five years of statin treatment did not change the number of new cancers or cancer deaths. Reassuringly, it also found no increase in cancer, even in people with very low LDL cholesterol.

In short, statins are prescribed to protect the heart and blood vessels. A possible effect on cancer is an area of active research, and any benefit may take longer than five years to appear, but cancer prevention on its own is not yet a reason to start a statin.

How do you balance the benefits and side effects of statins?

Muscle pain is the most common reason people stop statins, but in blinded trials most muscle complaints in people taking statins were not actually caused by the statin. Statins can slightly increase the chance of developing type 2 diabetes, mainly in people who already have risk factors such as high blood sugar or excess weight, and may slightly increase the risk of bleeding in the brain in people who have already had a stroke. For most people at risk of heart disease, the benefits clearly outweigh these risks. For more, read Statin side effects vs risk of stroke and heart attack.

How do genes affect statin side effects?

Variations in the SLCO1B1 and ABCG2 genes affect how statins are carried into the liver and cleared, and reduced function raises statin levels in the blood and the risk of muscle side effects. The CYP2C9 gene affects fluvastatin. The CPIC 2022 statin guideline uses these genes to recommend which statin and starting dose to choose. Drug and food interactions through the CYP3A4 enzyme, such as with clarithromycin or grapefruit juice, also raise the levels of some statins. Read more in Are statins safe? It depends on your genetics.

Can a pharmacogenetic test help?

The Pillcheck pharmacogenetic test reports your SLCO1B1, ABCG2, CYP2C9 and CYP3A4 status and your predicted response to statins and many other medications. It includes a medication review by an expert pharmacist, who checks for drug-gene and drug-drug interactions and sends recommendations to help your doctor choose the right statin and dose, so you can continue treatment with fewer side effects.

Summary

Statins prevent heart attacks and strokes and help people live longer, including older adults.
Genetic and population studies suggest statins may lower cancer risk, but trials over about five years have not shown an effect on cancer.
Other cholesterol-lowering drugs include ezetimibe, PCSK9 inhibitors, bempedoic acid and inclisiran.
Genetic testing for SLCO1B1, ABCG2 and CYP2C9, together with a medication review, can help you find a statin and dose you can tolerate.

Frequently asked questions

Do statins prevent cancer?

Genetic and population studies suggest a lower cancer risk or lower cancer death rate in statin users, but randomized trials lasting about five years found no effect on cancer.

Do statins cause cancer?

No. A large analysis of 27 trials found no increase in cancer with statins, even at very low LDL cholesterol levels.

Who should take a statin?

Most people who have had a heart attack or stroke, most people with diabetes or chronic kidney disease, people with very high LDL cholesterol, and others at high risk of heart disease. Your health care provider can estimate your risk.