title: Statins are associated with a reduced risk of cholangiocarcinoma: a population-based case-control study.
abstract: OBJECTIVE
  Cholangiocarcinoma (CCA) is the second most common primary liver cancer in the world. Due to the lack of effective treatments, the survival rate of CCA is low and it is usually considered difficult to diagnose early. To date, no effective strategies for the prevention of CCA have been developed. Statins are cholesterol-lowering agents which possess pleiotropic properties and the use of statins may reduce cancer risk. The aim of the study was to investigate the effect of statin use on the risk of CCA.
  
  
  METHODS
  We used nationwide insurance data to perform a case-control study including 3174 CCA patients diagnosed in 2002-2011 and 3174 propensity score matched controls. Odds ratios (ORs) and 95% confidence intervals (CI) were calculated to assess the association between CCA risk and statin use by type of statin and dose.
  
  
  RESULTS
  Patients with CCA were slightly younger than controls with mean ages of 67.4 (SD 12.3) and 68.5 (SD 13.2) years (P = 0.001), respectively, and had less users of statins (22.7 vs. 26.5%, P < 0.001). The overall adjusted OR of statin use associated CCA was 0.80 (95% CI 0.71, 0.90) and lowered for those with longer medications. The OR ranged from 0.65 to 0.77. Stronger dose-response association was seen when using lovastatin.
  
  
  CONCLUSIONS
  Statin use is associated with reduced risk of CCA and there is a dose-response relationship between the use of statins and risk of CCA.
authors: Division of Gastroenterology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.|National Yang-Ming University, Taipei, Taiwan.
authors: Yen-Chun
authors: YC
authors: Peng
authors: Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.|College of Medicine, China Medical University, Taichung, Taiwan.
authors: Cheng-Li
authors: CL
authors: Lin
authors: Department of Nursing, Taichung Veterans General Hospital, Taichung, Taiwan.
authors: Wan-Yun
authors: WY
authors: Hsu
authors: Division of Gastroenterology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
authors: Chi-Sen
authors: CS
authors: Chang
authors: Division of Gastroenterology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.|National Yang-Ming University, Taipei, Taiwan.
authors: Hong-Zen
authors: HZ
authors: Yeh
authors: Division of Gastroenterology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.|National Yang-Ming University, Taipei, Taiwan.
authors: Chun-Fang
authors: CF
authors: Tung
authors: Department of physiology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors: Yuh-Lin
authors: YL
authors: Wu
authors: Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.|Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
authors: Fung-Chang
authors: FC
authors: Sung
authors: Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.|Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.
authors: Chia-Hung
authors: CH
authors: Kao
mesh_terms: D000368:Aged; D001650:Bile Duct Neoplasms / Q000453:epidemiology*; D016022:Case-Control Studies; D018281:Cholangiocarcinoma / Q000453:epidemiology*; D004305:Dose-Response Relationship, Drug; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D013624:Taiwan / Q000453:epidemiology
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: case-control study; cholangiocarcinoma; insurance data; propensity score matching; statins