title: Statin use is associated with a reduced incidence of colorectal adenomatous polyps.
abstract: BACKGROUND
  Hydroxymethylglutaryl coenzyme A reductase inhibitors (statins) have been shown to have potentially useful anticancer effects against colorectal cancers in experimental studies, but clinical studies have shown inconsistent results on colorectal cancer incidence. Most colorectal cancers are believed to develop through the polyp-cancer sequence. We hypothesized that statins may protect against the development of adenomatous polyps, and this may contribute to the apparent cancer-protective effects.
  
  
  OBJECTIVE
  This study aims to compare previous statin use in patients with newly diagnosed adenomatous polyps against a control group without polyps.
  
  
  METHODS
  A case-control study involving 264 patients attending for diagnostic colonoscopy at the Norfolk and Norwich University Hospital was used. Polyp cases were age and sex matched against controls with normal colonoscopies. Structured patient interviews and clinical notes were used to ascertain drug and risk factor. Logistic regression was used to compare statin exposure and correct for confounding factors.
  
  
  RESULTS
  There was a significant negative association between prior statin use and a diagnosis of adenomatous polyps [odds ratio (OR) = 0.40 (0.24-0.76)]. The association was significantly stronger with higher statin doses [≥40 mg simvastatin or equivalent; OR 0.33 (0.10-0.53)] or longer duration of use [>5 years; OR 0.36 (0.10-0.67)]. Statin use was negatively associated with both high- and low-risk polyps.
  
  
  CONCLUSIONS
  Statins may have a protective effect against the development of adenomatous polyps. The negative association between statin use and polyp incidence showed a significant dose and duration relationship.
authors.affiliation: Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK.
authors.forename: Thomas
authors.initials: T
authors.lastname: Broughton
authors.forename: Jamie
authors.initials: J
authors.lastname: Sington
authors.forename: Ian L P
authors.initials: IL
authors.lastname: Beales
mesh_terms: D018256:Adenomatous Polyps / Q000453:epidemiology*; D001241:Aspirin / Q000627:therapeutic use; D016022:Case-Control Studies; D015986:Confounding Factors, Epidemiologic; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D015994:Incidence; D007417:Intestinal Polyps / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D001241:Aspirin