Risk of Colorectal Cancer in Patients Prescribed Statins, Nonsteroidal Anti-Inflammatory Drugs, and Cyclooxygenase-2 Inhibitors: Nested Case-Control Study
Background & Aims: Several studies suggest that statins prevent some cancers, with one study finding a 47% reduction in colorectal cancer risk after ≥5 years of regular use. Methods: A nested case-control study was conducted within 454 general practices in the United Kingdom using the QRESEARCH database. Cases with colorectal cancer were diagnosed between 1995 and 2005. The effects of statins, nonsteroidal anti-inflammatory drugs, cyclooxygenase-2 inhibitors, and aspirin on colorectal cancer were estimated with conditional logistic regression adjusted for morbidity, smoking status, body mass index, and socioeconomic status. Results: We analyzed 5686 cases and 24,982 matched controls with ≥4 years of records. The adjusted odds ratio for colorectal cancer associated with any statin prescription was 0.93 (95% confidence interval: 0.83–1.04), with no trend in duration of use or number of prescriptions. For any nonsteroidal anti-inflammatory drug prescription the adjusted odds ratio was 0.94 (95% confidence interval: 0.88–1.00), with a significant decrease in risk with increasing number of prescriptions and an adjusted odds ratio of 0.76 (0.60–0.95) for ≥25 prescriptions. Prolonged use of cyclooxygenase-2 inhibitors was minimal, but for those receiving ≥25 prescriptions the adjusted odds ratio was 0.34 (0.14–0.85). Results were similar in the subset of participants with ≥8 years of records; the adjusted odds ratio for ≥61 months of statin prescriptions was 1.00 (0.67–1.48). Conclusions: In this large population-based case-control study prolonged use of nonsteroidal anti-inflammatory drug and cyclooxygenase-2 inhibitor was associated with a reduced colorectal cancer risk, but prolonged statin use was not.
Abbreviations used in this paper: CI, confidence interval, COX-2, cyclooxygenase-2, GPRD, General Practice Research Database, NSAID, nonsteroidal anti-inflammatory drug, OR, odds ratio
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Supported by the University of Nottingham. This work was undertaken during the course of normal academic duties. The QResearch database undertakes other work for a variety of government organisations. This work was not commissioned or funded by any external organisation.
The study was initiated by JHC and designed by all the authors. The analysis was undertaken by YV and checked by JHC and CC. All authors contributed to the detailed analysis plan, interpretation of results, and drafting of the paper. YV and JHC are the guarantors of the study.
All authors declare that they have no conflict of interest to disclose.
PII: S0016-5085(07)01005-0
doi:10.1053/j.gastro.2007.05.023
© 2007 AGA Institute. Published by Elsevier Inc. All rights reserved.
