Statins and the Risk of Colorectal Cancer: A Meta-Analysis of 18 Studies Involving More Than 1.5 Million Patients

Bonovas, Stefanos; Filioussi, Kalitsa; Flordellis, Christodoulos S.; Sitaras, Nikolaos M.

doi:10.1200/jco.2007.10.8936

Cited by 127 publications

(117 citation statements)

References 51 publications

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“…A chemopreventive effect on colonic neoplasms by metformin, TZDs, lowdose aspirin, and NSAIDs has been suggested in epidemiologic trials (10-13); however, insulin therapy is associated with the development of colorectal cancer (14). Although a significant chemopreventive effect of statins against colon neoplasm was found in the current study, meta-analysis results failed to support this effect in patients on statin therapy (38).…”

Section: Discussioncontrasting

confidence: 55%

Use of an α-Glucosidase Inhibitor and the Risk of Colorectal Cancer in Patients With Diabetes: A Nationwide, Population-Based Cohort Study

et al. 2015

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OBJECTIVEAcarbose, an a-glucosidase inhibitor, has been shown to have antineoplastic effects on colorectal cancer in biomarker studies. We assessed the association between acarbose use in patients with diabetes and incident colorectal cancer. RESEARCH DESIGN AND METHODSWe conducted a nationwide, population-based study using a large cohort with diabetes in the Taiwan National Health Insurance Research Database. Patients with newly diagnosed diabetes (n = 1,343,484) were enrolled between 1998 and 2010. One control subject not using acarbose was randomly selected for each subject using acarbose after matching for age, sex, diabetes onset, and comorbidities. Cox proportional hazards regression with a competing risks analysis was used to calculate the hazard ratios (HRs) and 95% CIs for the association between acarbose use and incident colorectal cancer for each eligible case-control pair (n = 199,296). RESULTSThere were 1,332 incident cases of colorectal cancer in the cohort with diabetes during the follow-up period of 1,487,136 person-years. The overall incidence rate was 89.6 cases per 100,000 person-years. Patients treated with acarbose had a 27% reduction in the risk of colorectal cancer compared with control subjects. The adjusted HRs were 0.73 (95% CI 0.63-0.83), 0.69 (0.59-0.82), and 0.46 (0.37-0.58) for patients using >0 to <90, 90 to 364, and ‡365 cumulative defined daily doses of acarbose, respectively, compared with subjects who did not use acarbose (P for trend < 0.001). CONCLUSIONSAcarbose use reduced the risk of incident colorectal cancer in patients with diabetes in a dose-dependent manner.Colorectal cancer is one of the most common cancers worldwide (1), causing an estimated 694,000 deaths in 2012 or 9.2% of all cancer-related deaths (2). Fecal occult blood screening and improved treatment in recent decades have reduced the annual global mortality of colorectal cancer (3). The incidence of colorectal cancer varies widely by geographic region and by degree of development. Although

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Section: Discussioncontrasting

confidence: 55%

Use of an α-Glucosidase Inhibitor and the Risk of Colorectal Cancer in Patients With Diabetes: A Nationwide, Population-Based Cohort Study

et al. 2015

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“…I do not expect that statins would protect against only prostate cancer; their actions are quite diverse. On the other hand, the same consistency of findings between statins and the incidence of cancer overall (12,17,30) or lung (30), breast (31), colorectal (32), and hematologic (33) cancers has not been observed.…”

Section: )mentioning

confidence: 61%

Epidemiologic Musing on Statin Drugs in the Prevention of Advanced Prostate Cancer

Platz¹

2007

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…11 According to another meta-analysis of 18 published studies, there was no association between statin use and risk of colorectal cancer found in either randomized controlled studies (n 5 6) or prospective cohort studies (n 5 3). 12 However, the meta-analysis of retrospective case-control studies (n 5 9) indicated a statistically significant association between statin use and a modest reduction in the risk of colorectal cancer.…”

Section: Statin and Cancer Chemopreventionmentioning

confidence: 99%

Combination regimen with statins and NSAIDs: A promising strategy for cancer chemoprevention

Xiao

Yang

2008

Intl Journal of Cancer

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Statins and nonsteroidal antiinflammatory drugs (NSAIDs) are commonly prescribed for lowering cholesterol and antiinflammation, respectively. Recently, their potential roles as cancer chemopreventive agents have been subject to intensive studies. Human trials have not provided conclusive results on the protective effects of statins against different cancers, while more convincing results have been observed for cancer preventive effects of NSAIDs, especially on colorectal cancer. A promising strategy to enhance the cancer preventive efficacy of statins and NSAIDs is to use them in combination, which may produce synergy and lower the dose required for each agent. This strategy is of particular interest for potential use of low doses of statins and NSAIDs on a long-term basis for cancer chemoprevention; increased risks for gastrointestinal and cardiovascular side effects associated with the use of NSAIDs have been observed in colorectal cancer chemopreventive trials. This article reviews the evidence for the cancer preventive actions of statins and NSAIDs, as well as their possible synergistic action and the mechanisms involved. ' 2008 Wiley-Liss, Inc.Key words: statins; NSAIDs; cancer chemoprevention While the mortality from major chronic diseases, such as cardiovascular and cerebrovascular diseases, has decreased substantially during the past half century in the United States, the mortality from cancer has just begun to show a slight decrease. Cancer has become the number one killer of both men and women under age 85 years in the United States.1 A promising approach to controlling cancer is to prevent it before malignant events have occurred.2 Cancer chemoprevention refers to the use of natural or synthetic substances to inhibit, retard or reverse the carcinogenesis.3 A wealth of evidence from preclinical studies have convincingly demonstrated the cancer preventive efficacy of various agents in different animal models. However, the data from observational, case-control, cohort studies, and randomized trials in humans have overall demonstrated mixed results. Statins and nonsteroidal antiinflammatory drugs (NSAIDs) have been reported to be potential cancer chemopreventive agents. This review focuses on an attractive approach of chemoprevention using the combination of statins and NSAIDs. Statin and cancer chemopreventionStatins are small-molecule inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase, which are widely used as cholesterol-lowering drugs. Besides their use in the treatment of lipid disorders, statins have showed anticarcinogenic activities in many in vitro and in vivo preclinical studies, and attracted much attention in exploring their roles in cancer chemoprevention. Several observational human studies reported potential protective effects of statin use against overall risk of cancer, 4-6 whereas other studies did not 7,8 (Table I). In a case-control study in Quebec, Canada, statin use was found to be associated with a 28% reduction in the risk of developing cancer (RR 5 0.72, 95% ...

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Statins and the Risk of Colorectal Cancer: A Meta-Analysis of 18 Studies Involving More Than 1.5 Million Patients

Abstract: Our meta-analysis results do not support the hypothesis that statins strongly reduce the risk of colorectal cancer, when taken for management of hypercholesterolemia. However, we cannot rule out a modest reduction in risk or an effect associated with higher doses of statins.

Cited by 127 publications

References 51 publications

Use of an α-Glucosidase Inhibitor and the Risk of Colorectal Cancer in Patients With Diabetes: A Nationwide, Population-Based Cohort Study

Use of an α-Glucosidase Inhibitor and the Risk of Colorectal Cancer in Patients With Diabetes: A Nationwide, Population-Based Cohort Study

Epidemiologic Musing on Statin Drugs in the Prevention of Advanced Prostate Cancer

Combination regimen with statins and NSAIDs: A promising strategy for cancer chemoprevention

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