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Statin Use May Lower Risk of Colorectal Cancer in Patients with Ulcerative Colitis

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In an observational cohort study published in the September 2023 issue of The Lancet, Jiangwei Sun, Ph.D., from the Karolinska Institutet in Stockholm, Sweden, and his colleagues compared statin users with non-statin users to determine the risk of colorectal cancer in patients with IBD.

According to a recent study, patients with ulcerative colitis have an increased risk of developing and dying from colorectal cancer compared with the general population. It is generally believed that chronic inflammation in the gut is a major factor contributing to the increased incidence of colorectal cancer in ulcerative colitis.

Statin drugs, which are FDA-approved to lower cholesterol levels and reduce the risk of cardiovascular events, have been found to also possess anti-inflammatory properties. Some observational studies have reported a reduced risk of colorectal cancer in individuals taking statins. However, these studies did not focus specifically on patients with inflammatory bowel disease (IBD).

In an observational cohort study published in the September 2023 issue of The Lancet, Jiangwei Sun, Ph.D., from the Karolinska Institutet in Stockholm, Sweden, and his colleagues compared statin users with non-statin users to determine the risk of colorectal cancer in patients with IBD.

Using data from the Epidemiology Strengthened by histo-Pathology Reports in Sweden (ESPRESSO), Sun and his colleagues identified 5,273 patients with IBD who used statins between July 2006 and December 2018. The group was matched with a similar group of 5,273 IBD patients who did not use statins. After a mean follow-up period of about 5.6 years, the researchers found that 70 statin users and 90 non-statin users had been diagnosed with colorectal cancer.

Additionally, the study results showed fewer deaths due to colorectal cancer in the statin group versus the non-statin group (20 versus 37) and fewer deaths overall in the group of statin users compared with the non-statin users (529 versus 719).

The protective effects of the statins were duration-dependent, with significant benefits observed after two or more years of statin use. A statistically significant decreased risk of colorectal cancer and death due to colorectal cancer was seen only in patients with ulcerative colitis. The number of patients needed to be treated with statins to prevent one case of colorectal cancer in 10 years was 227, and 200 to avoid one death due to colorectal cancer.

The authors conclude that statins may lower the risk of colorectal cancer and colorectal cancer-related death in patients with ulcerative colitis. However, they recognize the need for additional research to confirm their findings.

They wrote, “Although further research is needed to define the optimal timing of initiation, exact dose, and minimum duration required to achieve benefits before safely incorporating statin into guidelines for [colorectal cancer] prevention in patients with IBD, our findings indeed provide evidence for the clinical use of statin as a well-tolerated and affordable cancer chemopreventive agent in patients with IBD.”

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