Table 3 Estimated parametric g-formula risk (%), risk difference (RD, %), risk ratio (RR), restricted mean event-free time (RMET, years), and restricted mean event-free based number needed to treat (NNT) to prevent one cancer death under natural course, treat-to-target interventions recommended by the 2020 Chinese Society of Cardiology and per 1 mmol/L LDL-C reduction after 29 years of follow-up from the Chinese Multi-provincial Cohort Study 1992-2020

From: Effectiveness of treat-to-target cholesterol-lowering interventions on cardiovascular disease and all-cause mortality risk in the community-dwelling population: a target trial emulation

Interventions

Cancer mortality

Risk (%, 95% CI)

RD (%, 95% CI)

RR (95% CI)

RMET (years)

NNT

Average % intervention

Natural course

8.6 (7.8 to 9.3)

Reference

Reference

28.4

Reference

0.0

Treat-to-target interventionsa

7.2 (3.8 to 11.3)

−1.4 (−4.7 to 2.4)

0.84 (0.45 to 1.27)

28.5

294

29%

Feasible interventionsb

7.2 (4.0 to 11.3)

−1.3 (−4.5 to 2.4)

0.85 (0.46 to 1.27)

28.5

310

27%

Per 1 mmol/L LDL-C reduction

8.3 (4.5 to 14.3)

-0.3 (−4.1 to 5.7)

0.86 (0.52 to 1.67)

28.4

1218

100%

  1. Note: a Treat-to-target cholesterol-lowering intervention is based on cholesterol-lowering targets recommended by the Chinese Society of Cardiology in 2020 on LDL-C and non-HDL-C levels, i.e., for participants with diabetes at high cardiovascular risk, lower the LDL-C to < 1.8 mmol/L (70 mg/dL, i.e., a fixed level drawed from a uniform distribution with a upper bound of 1.8 mmol/L) or LDL-C reduction to > 50% from baseline whichever is the lowest and non-HDL-C to < 2.6 mmol/L (100 mg/dL, i.e., a fixed level drawed from a uniform distribution with a upper bound of 2.6 mmol/L); for participants without diabetes who are at moderate-to-high cardiovascular risk lower the LDL-C to < 2.6 mmol/L (100 mg/dL, i.e., a fixed level drawed from a uniform distribution with a upper bound of 2.6 mmol/L) and non-HDL-C to < 3.4 mmol/L (130 mg/dL, i.e., a fixed level drawed from a uniform distribution with a upper bound of 3.4 mmol/L); for participants at low cardiovascular risk, lower LDL-C to < 3.4 mmol/L (130 mg/dL, i.e., a fixed level drawed from a uniform distribution with a upper bound of 3.4 mmol/L) and a non-HDL-C < 4.2 mmol/L (160 mg/dL, i.e., a fixed level drawed from a uniform distribution with a upper bound of 4.2 mmol/L).
  2. bFeasible treat-to-target cholesterol-lowering intervention, defined as 80% of eligible participants receiving the intervention at the follow-up examination over the study period.
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