title: Neither long-term statin use nor atherosclerotic disease is associated with risk of colorectal cancer.
abstract: OBJECTIVE
  Statin use has been reported to reduce risk for colorectal cancer (CRC) whereas atherosclerotic disease has been reported to increase risk, but findings have been inconsistent. We aimed to establish the association of statin use and coronary atherosclerosis with CRC.
  
  
  METHODS
  We performed a population-based case control study of patients with a first diagnosis of CRC cancer between January 1, 1991, and December 31, 2008 (n = 9979), using the Danish National Registry of Patients. As many as 10 population controls were matched to each patient using risk set sampling (n = 99,790). Statin use before cancer diagnosis (or control index date) was determined via county prescription databases and evidence of coronary atherosclerosis using International Classification of Diseases codes. We calculated incidence rate ratios using conditional logistic regression, adjusted for multiple covariates.
  
  
  RESULTS
  Among patients with CRC, statin use was modest (7.7%), but 23.5% of use was long term (≥5 years). Ever use of statins (≥2 prescriptions) slightly reduced CRC risk, compared with relative to never/rare use (incidence rate ratio [IRR] = 0.87, 95% confidence interval = 0.80-0.96). However, long-term use did not affect risk compared with never/rare use (IRR = 0.95, 95% 0.80-1.12). No associations were observed between atherosclerosis, myocardial infarction, or stroke, and CRC incidence.
  
  
  CONCLUSIONS
  Although there is a weak inverse association between ever use of statins and CRC incidence, there was no trend with increasing duration of use, so statins do not appear to reduce CRC risk. We did not confirm the reported association between atherosclerosis and CRC risk.
authors.affiliation: VA Medical Center, White River Junction, Vermont 05009, USA. douglas.robertson@va.gov
authors.forename: Douglas J
authors.initials: DJ
authors.lastname: Robertson
authors.forename: Anders Hammerich
authors.initials: AH
authors.lastname: Riis
authors.forename: Søren
authors.initials: S
authors.lastname: Friis
authors.forename: Lars
authors.initials: L
authors.lastname: Pedersen
authors.forename: John A
authors.initials: JA
authors.lastname: Baron
authors.forename: Henrik Toft
authors.initials: HT
authors.lastname: Sørensen
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D015179:Colorectal Neoplasms / Q000453:epidemiology*; D003324:Coronary Artery Disease / Q000150:complications*; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D015994:Incidence; D008297:Male; D018570:Risk Assessment
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors