title: The long-term use of statins is associated with a decreased incidence of adenomatous colon polyps.
abstract: OBJECTIVE
  Studies have suggested that statins may protect against colorectal cancer (CRC), but it is not clear whether that protection results from effects on established adenomatous polyps (APs) or from preventing the development of new APs. We have conducted a retrospective, cohort study to explore how the long-term use of statins influences the development of new APs.
  
  
  METHODS
  We reviewed endoscopy and pathology databases to identify patients with histologically verified APs, all of which were removed during an index colonoscopy, and who had a follow-up colonoscopy 3-5 years later. Patients were categorized as users or nonusers of statins by review of their medical and pharmacy records, and the characteristics of APs found on follow-up colonoscopy in the 2 groups was compared.
  
  
  RESULTS
  We identified 2,626 patients (84% men, mean age 62.2 years) with APs removed during an index colonoscopy. Of 1,688 patients (35%) who used statins continuously, 583 had an AP found on follow-up colonoscopy, compared to 477 of 938 patients (51%) who did not use statins continuously [odds ratio (OR) 0.51, 95% confidence interval (CI) 0.43-0.60; p < 0.01]. Statin use was associated with a smaller mean number of polyps (2.6 vs. 3.1; p = 0.002), a smaller mean polyp size (7.1 vs. 7.9 mm; p = 0.03) and a significant reduction in the incidence of advanced APs (OR 0.74, 95% CI 0.52-0.96; p = 0.03).
  
  
  CONCLUSIONS
  In patients with APs removed colonoscopically, long-term statin usage is associated with a decreased incidence of new and advanced APs. This suggests that statins may protect against CRC by reducing the development of new APs.
authors.affiliation: Department of Internal Medicine, Dallas Veterans Affairs Medical Center, Dallas, Tex. 75216, USA. ali.siddiqui@utsouthwestern.edu
authors.forename: Ali A
authors.initials: AA
authors.lastname: Siddiqui
authors.forename: Hector
authors.initials: H
authors.lastname: Nazario
authors.forename: Amar
authors.initials: A
authors.lastname: Mahgoub
authors.forename: Sandeep
authors.initials: S
authors.lastname: Pandove
authors.forename: Daisha
authors.initials: D
authors.lastname: Cipher
authors.forename: Stuart J
authors.initials: SJ
authors.lastname: Spechler
mesh_terms: D018256:Adenomatous Polyps / Q000453:epidemiology*; D016009:Chi-Square Distribution; D003111:Colonic Polyps / Q000453:epidemiology*; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000453:epidemiology*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014728:Veterans
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors