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Article

Statins and Colorectal Cancer Risk: A Population-Based Case-Control Study and Synthesis of the Epidemiological Evidence

1
Clinical Pharmacology Unit, University Hospital “Príncipe de Asturias”, 28805 Alcalá de Henares, Spain
2
Pharmacology Unit, Department of Biomedical Sciences, School of Medicine and Health Sciences, University of Alcalá (IRYCIS), 28805 Alcalá de Henares, Spain
3
Spanish Centre for Pharmacoepidemiologic Research (CEIFE), 28004 Madrid, Spain
4
BIFAP Unit, Pharmacoepidemiology and Pharmacovigilance Division, Spanish Agency for Medicines and Clinical Devices (AEMPS), 28022 Madrid, Spain
5
Department of Cardiology, University Hospital “Príncipe de Asturias”, 28805 Alcalá de Henares, Spain
6
Department of Medicine and Medical Specialties, School of Medicine and Health Sciences, University of Alcalá, 28805 Alcalá de Henares, Spain
*
Author to whom correspondence should be addressed.
Academic Editors: Antonio J. Carcas-Sansuán and Alberto M. Borobia Pérez
J. Clin. Med. 2022, 11(6), 1528; https://doi.org/10.3390/jcm11061528
Received: 12 January 2022 / Revised: 2 March 2022 / Accepted: 8 March 2022 / Published: 10 March 2022
(This article belongs to the Collection Practice and Research in Clinical Pharmacology)
(1) Background: The pleiotropic effects of statins may explain a chemoprotective action against colorectal cancer (CRC). Many studies have tested this hypothesis, but results have been inconsistent so far. Moreover, few have examined statins individually which is important for determining whether there is a class effect and if lipophilicity and intensity may play a role. (2) Methods: From 2001–2014, we carried out a study comprised of 15,491 incident CRC cases and 60,000 matched controls extracted from the primary healthcare database BIFAP. We fit a logistic regression model to compute the adjusted-odds ratios (AOR) with their 95% confidence intervals (CIs). Additionally, we carried out a systematic review and meta-analysis. (3) Results: Current use of statins showed a reduced risk of CRC (AOR = 0.87; 95% CI: 0.83–0.91) not sustained after discontinuation. The association was time-dependent, starting early (AOR6months–1year = 0.85; 95% CI: 0.76–0.96) but weakened beyond 3-years. A class effect was suggested, although only significant for simvastatin and rosuvastatin. The risk reduction was more marked among individuals aged 70 or younger, and among moderate-high intensity users. Forty-eight studies were included in the meta-analysis (pooled-effect-size = 0.90; 95% CI: 0.86–0.93). (4) Conclusions: Results from the case-control study and the pooled evidence support a moderate chemoprotective effect of statins on CRC risk, modified by duration, intensity, and age. View Full-Text
Keywords: statin; colorectal cancer; chemoprevention; real-world data; real-world evidence statin; colorectal cancer; chemoprevention; real-world data; real-world evidence
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MDPI and ACS Style

Rodríguez-Miguel, A.; Fernández-Antón, E.; Barreira-Hernández, D.; García-Rodríguez, L.A.; Gil, M.; García-Lledó, A.; De Abajo, F.J. Statins and Colorectal Cancer Risk: A Population-Based Case-Control Study and Synthesis of the Epidemiological Evidence. J. Clin. Med. 2022, 11, 1528. https://doi.org/10.3390/jcm11061528

AMA Style

Rodríguez-Miguel A, Fernández-Antón E, Barreira-Hernández D, García-Rodríguez LA, Gil M, García-Lledó A, De Abajo FJ. Statins and Colorectal Cancer Risk: A Population-Based Case-Control Study and Synthesis of the Epidemiological Evidence. Journal of Clinical Medicine. 2022; 11(6):1528. https://doi.org/10.3390/jcm11061528

Chicago/Turabian Style

Rodríguez-Miguel, Antonio, Encarnación Fernández-Antón, Diana Barreira-Hernández, Luis A. García-Rodríguez, Miguel Gil, Alberto García-Lledó, and Francisco J. De Abajo. 2022. "Statins and Colorectal Cancer Risk: A Population-Based Case-Control Study and Synthesis of the Epidemiological Evidence" Journal of Clinical Medicine 11, no. 6: 1528. https://doi.org/10.3390/jcm11061528

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