Statins and the risk of colorectal cancer.
BACKGROUND
Statins are inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A reductase and effective lipid-lowering agents. Statins inhibit the growth of colon-cancer cell lines, and secondary analyses of some, but not all, clinical trials suggest that they reduce the risk of colorectal cancer.


METHODS
The Molecular Epidemiology of Colorectal Cancer study is a population-based case-control study of patients who received a diagnosis of colorectal cancer in northern Israel between 1998 and 2004 and controls matched according to age, sex, clinic, and ethnic group. We used a structured interview to determine the use of statins in the two groups and verified self-reported statin use by examining prescription records in a subgroup of patients for whom prescription records were available.


RESULTS
In analyses including 1953 patients with colorectal cancer and 2015 controls, the use of statins for at least five years (vs. the nonuse of statins) was associated with a significantly reduced relative risk of colorectal cancer (odds ratio, 0.50; 95 percent confidence interval, 0.40 to 0.63). This association remained significant after adjustment for the use or nonuse of aspirin or other nonsteroidal antiinflammatory drugs; the presence or absence of physical activity, hypercholesterolemia, and a family history of colorectal cancer; ethnic group; and level of vegetable consumption (odds ratio, 0.53; 95 percent confidence interval, 0.38 to 0.74). The use of fibric-acid derivatives was not associated with a significantly reduced risk of colorectal cancer (odds ratio, 1.08; 95 percent confidence interval, 0.59 to 2.01). Self-reported statin use was confirmed for 276 of the 286 participants (96.5 percent) who reported using statins and whose records were available.


CONCLUSIONS
The use of statins was associated with a 47 percent relative reduction in the risk of colorectal cancer after adjustment for other known risk factors. Because the absolute risk reduction is likely low, further investigation of the overall benefits of statins in preventing colorectal cancer is warranted.
Poynter
Jenny N
JN
Department of Epidemiology, University of Michigan, Ann Arbor 48109-0638, USA.
Gruber
Stephen B
SB
Higgins
Peter D R
PD
Almog
Ronit
R
Bonner
Joseph D
JD
Rennert
Hedy S
HS
Low
Marcelo
M
Greenson
Joel K
JK
Rennert
Gad
G
D000368:Aged; D016022:Case-Control Studies; D015179:Colorectal Neoplasms / Q000208:ethnology / Q000517:prevention & control*; D004034:Diet Surveys; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007557:Israel / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D010375:Pedigree; D012306:Risk; D012307:Risk Factors
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors