title: The role of statins for primary prevention in non-elderly colorectal cancer patients.
abstract: BACKGROUND
  There is conflicting evidence for the role of statins in the primary prevention of colorectal cancer (CRC). We conducted a case control study (N=357,702) in the non-elderly adult US population (age=18-64 years) with the primary objective to examine the association between CRC and statin use.
  
  
  METHODS
  MarketScan® databases were used to identify patients with CRC. A case was defined as having an incident diagnosis of CRC. Up to ten individually matched controls (age, sex, region and date of diagnosis) were selected per case. Statin exposure was assessed by prescription tracking in the 12 months prior to the index date. Conditional logistic regression was used to adjust for multiple potential confounders and calculate adjusted odds ratios (AOR).
  
  
  RESULTS
  The mean age of participants was 54 years; 52% males and 48% females. In a multivariable model, any statin use was associated with 26% reduced odds of CRC (AOR, 0.74, 95% confidence interval (CI), 0.72-0.77, p<0.001). Age-stratified analyses showed a stronger effect of statins on CRC in participants aged 55 years or younger (AOR, 0.67, 95% CI, 0.63-0.71, p<0.001) than in participants aged above 55 years (AOR, 0.79, 95% CI, 0.76-0.82, p<0.001); the age-by-statin interaction was statistically significant (p<0.001). The dose-response analyses performed with simvastatin only showed a trend towards significance between the duration of simvastatin exposure and odds of developing CRC (p=0.06).
  
  
  CONCLUSIONS
  Statins appears to reduce the risk of CRC in non-elderly US population. Chemoprevention with statin might be more effective in non-elderly US population.
authors.affiliation: Section of Hematology Oncology, Department of Medicine, University of Chicago, Chicago, IL, U.S.A. amikar.sehdev@uchospitals.edu.
authors.forename: Amikar
authors.initials: A
authors.lastname: Sehdev
authors.affiliation: Section of Hospital Medicine, Department of Medicine, University of Chicago, Chicago, IL, U.S.A.
authors.forename: Ya-Chen T
authors.initials: YC
authors.lastname: Shih
authors.affiliation: Department of Health Studies, University of Chicago, Chicago, IL, U.S.A.
authors.forename: Dezheng
authors.initials: D
authors.lastname: Huo
authors.affiliation: The Center for Health and the Social Sciences, University of Chicago, Chicago, IL, U.S.A.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Vekhter
authors.affiliation: The Center for Health and the Social Sciences, University of Chicago, Chicago, IL, U.S.A.
authors.forename: Christopher
authors.initials: C
authors.lastname: Lyttle
authors.affiliation: Section of Hematology Oncology, Department of Medicine, University of Chicago, Chicago, IL, U.S.A.
authors.forename: Blase
authors.initials: B
authors.lastname: Polite
mesh_terms: D000367:Age Factors; D016022:Case-Control Studies; D018890:Chemoprevention; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000517:prevention & control*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: MarketScan® database; Statin; colorectal cancer; non-elderly; prevention