Long-term use of statins and risk of colorectal cancer: a population-based study.
OBJECTIVE
We conducted a population-based cohort study to determine the effect of long-term regular use of statins on the risk of colorectal cancer (CRC).


METHODS
Individuals who were dispensed statins regularly were identified from Manitoba's population-based prescription drug database and followed up until diagnosis of CRC, migration out of province, death, or December 2005. The incidence of CRC in this group was compared with that among individuals who were never dispensed statins. Stratified analysis was performed to determine the risk after 5 years of regular statin use. Multivariate Poisson regression models were used to adjust for potential confounding by age, sex, and history of diabetes, inflammatory bowel disease, coronary heart disease, lower gastrointestinal endoscopy, resective colorectal surgery, use of nonsteroidal anti-inflammatory drugs, hormone replacement therapy (among women), and median household income. The dose effect was evaluated in defined daily dose units.


RESULTS
In total, 35,739 individuals were dispensed statins regularly. In all, 10,287 (49% males; 51% females) long-term (>or=5 years) regular statin users were followed up for up to 5 additional years. In multivariate analysis, the incidence rate ratio (IRR) of CRC among those dispensed statins regularly compared with those who were never dispensed statins (n=377,532) was 1.13 (95% confidence interval (CI): 1.02-1.25). The CRC risk among the long-term regular statin users was similar to that for individuals never dispensed statins (IRR, 0.89; 95% CI: 0.70-1.13). A statistically nonsignificant risk reduction was observed among high-dose long-term regular statin users.


CONCLUSIONS
These findings suggest that long-term regular use of statins for the current clinical indications does not protect against CRC. The benefit of high-dose long-term statin use needs further evaluation.
Singh
Harminder
H
Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada. singh@cc.umanitoba.ca
Mahmud
Salaheddin M
SM
Turner
Donna
D
Xue
Lin
L
Demers
Alain A
AA
Bernstein
Charles N
CN
D000368:Aged; D016009:Chi-Square Distribution; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000517:prevention & control*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D015994:Incidence; D008297:Male; D008350:Manitoba / Q000453:epidemiology; D008875:Middle Aged; D016012:Poisson Distribution; D012042:Registries; D012307:Risk Factors; D012923:Social Class
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors