1. Statin use following diagnosis of colorectal cancer was associated with dose-dependent reductions in cancer-specific and all-cause mortality.
Evidence Rating Level: 2 (Good)
Study Rundown: Though primarily used in the management of hyperlipidemia and coronary heart disease, preclinical evidence has suggested that statins may play a role as adjuvant cancer therapy. Previous studies have demonstrated reduced mortality among colorectal cancer patients taking statins in a small cohort. The purpose of this study was to evaluate the relationship between statins and cancer-specific and all-cause mortality in over 7,500 patients diagnosed with colorectal cancer in the United Kingdom from 1998 to 2009. At the conclusion of this study, the authors found that statin use after diagnosis of colorectal cancer was associated with a 28% reduction in cancer-specific mortality in a dose-dependent relationship. Furthermore, statin use was also associated with reduced all-cause mortality. These results benefit from the large sample size with extended follow-up. However, potential confounders such as medication non-adherence and healthy user effects should be noted.
Relevant Reading: Effect of statin therapy on colorectal cancer
In-Depth [retrospective cohort]: A total of 7,657 patients newly diagnosed with stage I-III colorectal cancer were identified from the National Cancer Data Repository (NCDR), United Kingdom Clinical Practice Research Datalink (CPRD) and the Office of National Statistics (ONS). Patients were excluded for previous NCDR cancer diagnoses, stage IV disease, or if they died in the first year following diagnosis. Average follow-up after diagnosis was 5 years. Compared to non-statin users, statin users had similar stage and grade of cancer but were more likely to be male, be older, to have a higher BMI, to have smoked, to have other comorbidities, and to use other medications. Overall, statin users had 28% reduction in rate of colorectal cancer-specific mortality compared to nonusers (HR 0.72; 95% CI, 0.64-0.81). A dose-dependent effect was observed as there was a 21% reduction in cancer-specific mortality among individuals with <1 year’s use and a 35% reduction in cancer-specific mortality among those with >1 year’s use. There was a 12% reduction in the rate of all-cause mortality in statin users (HR 0.88; 95% CI, 0.66 to 0.84).
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