Statin use and risk of colorectal cancer in patients with inflammatory bowel disease.
EClinicalMedicine
; 63: 102182, 2023 Sep.
Article
de En
| MEDLINE
| ID: mdl-37662517
ABSTRACT
Background:
Statin use has been linked to a reduced risk of advanced colorectal adenomas, but its association with colorectal cancer (CRC) in patients with inflammatory bowel disease (IBD) - a high risk population for CRC - remains inconclusive.Methods:
From a nationwide IBD cohort in Sweden, we identified 5273 statin users and 5273 non-statin users (11 propensity score matching) from July 2006 to December 2018. Statin use was defined as the first filled prescription for ≥30 cumulative defined daily doses and followed until December 2019. Primary outcome was incident CRC. Secondary outcomes were CRC-related mortality and all-cause mortality. Cox regression estimated adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs).Findings:
During a median follow-up of 5.6 years, 70 statin users (incidence rate (IR) 21.2 per 10,000 person-years) versus 90 non-statin users (IR 29.2) were diagnosed with incident CRC (rate difference (RD), -8.0 (95% CIs -15.8 to -0.2 per 10,000 person-years); aHR = 0.76 (95% CIs 0.61 to 0.96)). The benefit for incident CRC was duration-dependent in a nested case-controldesign:
as compared to short-term use (30 days to <1 year), the adjusted odd ratios were 0.59 (0.25 to 1.43) for 1 to <2 years of use, 0.46 (0.21 to 0.98) for 2 to <5 years of use, and 0.38 (0.16 to 0.86) for ≥5 years of use (Pfor tread = 0.016). Compared with non-statin users, statin users also had a decreased risk for CRC-related mortality (IR 6.0 vs. 11.9; RD, -5.9 (-10.5 to -1.2); aHR, 0.56 (0.37 to 0.83)) and all-cause mortality (IR 156.4 vs. 231.4; RD, -75.0 (-96.6 to -53.4); aHR, 0.63 (0.57 to 0.69)).Interpretation:
Statin use was associated with a lower risk of incident CRC, CRC-related mortality, and all-cause mortality. The benefit for incident CRC was duration-dependent, with a significantly lower risk after ≥2 years of statin use.Funding:
This research was supported by Forte (i.e., the Swedish Research Council for Health, Working Life and Welfare).
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Type d'étude:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Langue:
En
Journal:
EClinicalMedicine
Année:
2023
Type de document:
Article
Pays d'affiliation:
Suède