Statins and Colorectal Cancer Risk: A Population-Based Case-Control Study and Synthesis of the Epidemiological Evidence

Abstract

(1) Background: The pleiotropic effects of statins may explain a chemoprotective action against colorectal cancer (CRC). Many studies have tested this hypothesis, but results have been inconsistent so far. Moreover, few have examined statins individually which is important for determining whether there is a class effect and if lipophilicity and intensity may play a role. (2) Methods: From 2001–2014, we carried out a study comprised of 15,491 incident CRC cases and 60,000 matched controls extracted from the primary healthcare database BIFAP. We fit a logistic regression model to compute the adjusted-odds ratios (AOR) with their 95% confidence intervals (CIs). Additionally, we carried out a systematic review and meta-analysis. (3) Results: Current use of statins showed a reduced risk of CRC (AOR = 0.87; 95% CI: 0.83–0.91) not sustained after discontinuation. The association was time-dependent, starting early (AOR6months–1year = 0.85; 95% CI: 0.76–0.96) but weakened beyond 3-years. A class effect was suggested, although only significant for simvastatin and rosuvastatin. The risk reduction was more marked among individuals aged 70 or younger, and among moderate-high intensity users. Forty-eight studies were included in the meta-analysis (pooled-effect-size = 0.90; 95% CI: 0.86–0.93). (4) Conclusions: Results from the case-control study and the pooled evidence support a moderate chemoprotective effect of statins on CRC risk, modified by duration, intensity, and age.

Serum uric acid and the risk of colorectal cancer: a meta-analysis

“…Second, although the results of the meta-analysis were on the basis of multivariate observational studies, we could not exclude the possibility that there are still unadjusted factors which may confound the association between serum UA and CRC incidence. For example, people with high serum UA are likely to have other metabolic disorders such as dyslipidemia (Copur et al ., 2022), while the use of lipid-lowering medications such as statin has been related to a reduced risk of CRC (Rodriguez-Miguel et al ., 2022). In addition, allopurinol, a well-known UA-lowering drug, has also been related to a decreased risk of CRC (Hsu et al ., 2021), which may also confound the association between serum UA and CRC risk.…”

XGBoost algorithm and logistic regression to predict the postoperative 5-year outcome in patients with glioma

“…According to some previous studies, statins have received extensive attention in clinical practice. In many previous clinical studies, statins have been shown to have favorable effect on the reduction of the risk of cancers (20)(21)(22) and the risk of deaths due to cancers (23). However, there have also been reports of increased tumor risk (24,25) and others showing no definite relationship between statins and the occurrence, progression and long-term outcome (26).…”

The role of gut microbiota and drug interactions in the development of colorectal cancer

“…As lipid-lowering agents, statins are among the chemopreventive agents for CRC and play an important role in the treatment and prognosis of CRC. A population-based case-control study found statins to be moderately chemoprotective against CRC ( Rodríguez-Miguel et al, 2022 ). After undergoing a colonoscopy, statin users were found to have a lower risk of CRC ( Cheung et al, 2019 ).…”