Chronic statin therapy and the risk of colorectal cancer

Authors

  • Yu-Xiao Yang MD, MSCE,

    Corresponding author
    1. Division of Gastroenterology, University of Pennsylvania, Philadelphia, PA, USA
    2. Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, USA
    3. Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, USA
    • Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania 722 Blockley Hall, 423 Guardian Drive Philadelphia, PA 19104-6021, USA.
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  • Sean Hennessy PharmD, PhD,

    1. Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, USA
    2. Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, USA
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  • Kathleen Propert PhD,

    1. Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, USA
    2. Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, USA
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  • Wei-Ting Hwang PhD,

    1. Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, USA
    2. Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, USA
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  • Monika Sarkar MD,

    1. Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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  • James D. Lewis MD, MSCE

    1. Division of Gastroenterology, University of Pennsylvania, Philadelphia, PA, USA
    2. Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, USA
    3. Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, USA
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  • Yang has served as a consultant for AstraZeneca and has received grant support from AstraZeneca, Wyeth–Ayerst Laboratories, and GlaxoSmithKline. Dr Hennessy and Dr Lewis have served as a consultant for Wyeth–Ayerst Laboratories. All other authors have no conflict of interest to disclose.

Abstract

Background and Aims

Epidemiologic studies on a potential chemopreventive effect of statin therapy have yielded conflicting results. We sought to clarify whether long-term statin therapy has a chemopreventive effect on the risk of colorectal cancer (CRC) in a large, population-representative cohort.

Methods

A nested case–control study was conducted among patients ≥50 years of age and with ≥5 years of CRC-free initial follow-up in the General Practice Research Database (GPRD; 1987–2002). Cases consisted of all patients with incident CRC. Up to 10 controls were matched with each case on practice site and both duration and calendar time of follow-up prior to the index date. The primary exposure of interest was ≥5 years of cumulative statin use.

Results

We identified 4432 incident CRC cases and 44 292 controls. The adjusted odds ratio (OR) for ≥5 years of statin exposure was 1.1 (95% confidence interval (CI): 0.5–2.2). Chronic NSAID/aspirin use did not modify this primary association (test for interaction, p = 0.5). Compared to statin non-users, the adjusted OR for 10 years of statin exposure was 1.3 (95% CI: 0.6–2.7), and the adjusted OR associated with the highest quartile of cumulative statin dose was 1.2 (95% CI: 0.9–1.7). There was a non-statistically significant trend towards a possible reduction in CRC risk among users of high daily statin dose.

Conclusion

Long-term statin therapy at usual doses was not associated with a significantly reduced risk of CRC. A chemopreventive effect at high daily doses cannot be excluded. Copyright © 2008 John Wiley & Sons, Ltd.

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