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Statin use Linked to Reduced Colorectal Cancer Mortality
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The use of statins appeared associated with lower all-cause and cancer-specific mortality among patients with colorectal cancer, according to results of a meta-analysis published in Cancer Medicine.
Researchers observed the benefit regardless of whether the patients began taking statins before or after diagnosis.
“While many preclinical researches on cells and animals have indicated the positive effects of statins on [colorectal cancer], such as increasing intracellular oxidative stress, inducing apoptosis and augmenting chemosensitivity, whether statin uses are positively correlated with the survival of [patients with colorectal cancer] in clinic is controversial,” Yue Li, MD, of the department of gastroenterology at Zhejiang University Medical School, and colleagues wrote. “No consensus concerning the prognostic effects of statins on [colorectal cancer] has been reached so far. Our results may provide further insights into clinical applications of statins on [patients with colorectal cancer].”
The systematic review and meta-analysis by Li and colleagues included 14 studies that involved nearly 131,000 patients with colorectal cancer. The researchers identified the studies by searching PubMed, the Cochrane Library, Web of Science, EMBASE and SCOPUS. Six studies (n = 86,622) reported the association of statin use before diagnosis with colorectal cancer mortality, and 11 studies (n = 44,322) reported the association of postdiagnosis statin use with mortality.
Three of these studies were excluded from the final analysis.
Results showed prediagnostic statin use significantly lowered the risk for all-cause mortality (pooled HR = 0.85; 95% CI, 0.79-0.92) and cancer-specific mortality (pooled HR = 0.82; 95% CI, 0.79-0.86).
Post-diagnostic statin use also appeared associated with significantly lower all-cause mortality (pooled HR = 0.86; 95% CI, 0.76-0.98) and cancer-specific mortality (pooled HR = 0.79; 95% CI, 0.7-0.89).
A subgroup analysis based on KRAS mutation status showed no statistical difference in all-cause mortality between statin and nonstatin users. The pooled HR for all-cause mortality among patients with a KRAS mutation was 0.85 (95% CI, 0.61-1.18) and 0.81 (95% CI, 0.64-1.03) for patients with KRAS wild-type mutations.
Future studies should further analyze other possible sources of heterogeneity, including use of nonsteroid anti-inflammatory drugs, statin dose and duration, location of colorectal cancer, and pathological differentiation, researchers noted.
“Our meta-analysis demonstrates that both prediagnosis and postdiagnosis statin uses are associated with reduced all-cause mortality and cancer-specific mortality in [patients with colorectal cancer],” Li and colleagues wrote. “Considering that statins are low cost and widely used agents worldwide, we believe our updated meta-analysis can provide new insights into optimizing adjuvant treatment of colorectal cancer.” – by John DeRosier
Disclosures: The authors report no relevant financial disclosures.
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