title: Statin Use Is Associated With Improved Prognosis of Colorectal Cancer in Taiwan.
abstract: BACKGROUND
  Statins are widely used for hyperlipidemia control and might also exhibit anticancer properties. This study explored whether statin use is associated with the prognosis of curatively resected colorectal cancer (CRC).
  
  
  METHODS
  Using data from the Taiwan Cancer Registry, we established a population-based cohort of patients who received curative surgery for stage I, II, or III CRC. Data related to prescription medications and comorbidities were retrieved from the database of the National Health Insurance program of Taiwan. Statin users were defined as patients who had used statins within 1 year before their cancer diagnosis. Univariate and multivariate analyses were used to compare cancer-specific survival (CSS) and overall survival (OS) between statin users and patients who had never used statins (never users). In the multivariate analysis, we used propensity scores to adjust for age, sex, diagnosis year, physician visits, hospitalization, conjunctive medications, and comorbidities.
  
  
  RESULTS
  A total of 17,115 patients were enrolled; 2145 (13%) of these patients were statin users, and 14,970 (87%) were never users. After adjusting for other potential prognostic factors, statin use was an independent predictor for longer CSS (hazard ratio [HR], 0.77; 95% confidence interval [CI], 0.68-0.88; P < .001) and OS (HR, 0.82; 95% CI, 0.74-0.92; P < .001). These associations were consistent across subgroups, including sexes, tumor stages, and age cohorts, and in CRC patients who suffered from diabetes and hypertension.
  
  
  CONCLUSIONS
  Statin use is associated with an improved prognosis of curatively resected CRC.
authors.affiliation: Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Yu-Yun
authors.initials: YY
authors.lastname: Shao
authors.affiliation: Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Chih-Hung
authors.initials: CH
authors.lastname: Hsu
authors.affiliation: Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Kun-Huei
authors.initials: KH
authors.lastname: Yeh
authors.affiliation: Center for Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Ho-Min
authors.initials: HM
authors.lastname: Chen
authors.affiliation: Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
authors.forename: Yi-Chun
authors.initials: YC
authors.lastname: Yeh
authors.affiliation: Center for Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Chiu-Lin
authors.initials: CL
authors.lastname: Lai
authors.affiliation: Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Zhong-Zhe
authors.initials: ZZ
authors.lastname: Lin
authors.affiliation: Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address: alcheng@ntu.edu.tw.
authors.forename: Ann-Lii
authors.initials: AL
authors.lastname: Cheng
authors.affiliation: Center for Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, National Taiwan University Hospital, Taipei, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Taiwan Cancer Registry, Taipei, Taiwan. Electronic address: mslai@cph.ntu.edu.tw.
authors.forename: Mei-Shu
authors.initials: MS
authors.lastname: Lai
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D016208:Databases, Factual; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage* / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D012042:Registries; D015996:Survival Rate; D013624:Taiwan
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Colon cancer; Database analysis; National Health Insurance; Rectal cancer; Survival