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Chronic statin therapy and the risk of colorectal cancer
Author(s) -
Yang YuXiao,
Hennessy Sean,
Propert Kathleen,
Hwang WeiTing,
Sarkar Monika,
Lewis James D.
Publication year - 2008
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/pds.1599
Subject(s) - medicine , statin , odds ratio , aspirin , confidence interval , quartile , pharmacoepidemiology , colorectal cancer , population , cohort study , cohort , cancer , pharmacology , environmental health , medical prescription
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.