Statins and the risk of colorectal cancer

Jenny N. Poynter, Stephen B. Gruber, Peter D.R. Higgins, Ronit Almog, Joseph D. Bonner, Hedy S. Rennert, Marcelo Low, Joel K. Greenson, Gad Rennert

Research output: Contribution to journalArticle

607 Scopus citations

Abstract

BACKGROUND: Statins are inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A reductase and effective lipid-lowering agents. Statins inhibit the growth of colon-cancer cell lines, and secondary analyses of some, but not all, clinical trials suggest that they reduce the risk of colorectal cancer. METHODS: The Molecular Epidemiology of Colorectal Cancer study is a population-based case-control study of patients who received a diagnosis of colorectal cancer in northern Israel between 1998 and 2004 and controls matched according to age, sex, clinic, and ethnic group. We used a structured interview to determine the use of statins in the two groups and verified self-reported statin use by examining prescription records in a subgroup of patients for whom prescription records were available. RESULTS: In analyses including 1953 patients with colorectal cancer and 2015 controls, the use of statins for at least five years (vs. the nonuse of statins) was associated with a significantly reduced relative risk of colorectal cancer (odds ratio, 0.50; 95 percent confidence interval, 0.40 to 0.63). This association remained significant after adjustment for the use or nonuse of aspirin or other nonsteroidal antiinflammatory drugs; the presence or absence of physical activity, hypercholesterolemia, and a family history of colorectal cancer; ethnic group; and level of vegetable consumption (odds ratio, 0.53; 95 percent confidence interval, 0.38 to 0.74). The use of fibric-acid derivatives was not associated with a significantly reduced risk of colorectal cancer (odds ratio, 1.08; 95 percent confidence interval, 0.59 to 2.01). Self-reported statin use was confirmed for 276 of the 286 participants (96.5 percent) who reported using statins and whose records were available. CONCLUSIONS: The use of statins was associated with a 47 percent relative reduction in the risk of colorectal cancer after adjustment for other known risk factors. Because the absolute risk reduction is likely low, further investigation of the overall benefits of statins in preventing colorectal cancer is warranted.

Original languageEnglish (US)
Pages (from-to)2184-2192
Number of pages9
JournalNew England Journal of Medicine
Volume352
Issue number21
DOIs
StatePublished - May 26 2005

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    Poynter, J. N., Gruber, S. B., Higgins, P. D. R., Almog, R., Bonner, J. D., Rennert, H. S., Low, M., Greenson, J. K., & Rennert, G. (2005). Statins and the risk of colorectal cancer. New England Journal of Medicine, 352(21), 2184-2192. https://doi.org/10.1056/NEJMoa043792