2023-09-26 15:52:22
Taking statins has been associated in some observational studies with a reduction in the risk of colorectal cancer (CRC) in the general population. In patients with inflammatory bowel diseases (IBD) – who have an increased risk of CRC – this association has also been explored, but the studies have several limitations (small samples, inclusion of patients with CRC, different ways of assessing statin use, etc.) and their results are heterogeneous. Furthermore, in vitro studies have shown that, in addition to their cholesterol-lowering effect, statins can have anti-inflammatory, pro-apoptotic and antineoplastic effects, but conclusive results from clinical studies are lacking.
A Swedish observational study of more than 10,000 patients with IBD therefore studied this association, using a national prospective cohort. Its results have just been published in the Lancet
.
The authors included, between 2006 and 2018, 5,273 people treated with statins, which they compared to 5,273 people not taking this treatment. Data on statin consumption were collected through national drug prescription registers (there were no data on adherence). The researchers examined, following a median duration of 5.6 yearsthe occurrence of CRC in each group (primary endpoint), as well as colorectal cancer mortality and all-cause mortality (secondary endpoints).
Result : the incidence of CRC was lower in the group taking statins (21.2 per 10,000 person-years, compared to 29.2 per 10,000 person-years in the second group, i.e. aHR = 0,76). This effect was even more pronounced if the treatment was prolonged : thus, the aHR was 0.59 for patients who took statins for 1 to 2 years; 0.46 for a treatment duration of 2 to 5 years; of 0.38, i.e. a risk reduced by 62%, for a period of more than 5 years. Furthermore, CRC mortality was also lower in the first group (aHR = 0.56), as well as all-cause mortality (aHR = 0.63).
These benefits were observed particularly in patients with ulcerative colitis and those diagnosed with IBD before the age of 50.
Although certain information on participants’ exposure to known risk factors for CRC (smoking, sedentary lifestyle, consumption of alcohol, red meat, etc.) might not be collected in this study, the results suggest that taking statins may be associated with a reduced risk of CRC in patients with IBD. This reduction is considered significant from 2 years of treatment.
1695743971
#IBD #colorectal #cancer #statins #reduce #risk
