Statin use and risk of colorectal cancer in patients with inflammatory bowel diseaseResearch in context
Summary: 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 Swe...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-09-01
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| Series: | EClinicalMedicine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589537023003590 |
| _version_ | 1797736798778032128 |
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| author | Jiangwei Sun Jonas Halfvarson David Bergman Fahim Ebrahimi Bjorn Roelstraete Paul Lochhead Mingyang Song Ola Olén Jonas F. Ludvigsson |
| author_facet | Jiangwei Sun Jonas Halfvarson David Bergman Fahim Ebrahimi Bjorn Roelstraete Paul Lochhead Mingyang Song Ola Olén Jonas F. Ludvigsson |
| author_sort | Jiangwei Sun |
| collection | DOAJ |
| description | Summary: 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 (1:1 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-control design: 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 (P for 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). |
| first_indexed | 2024-03-12T13:19:09Z |
| format | Article |
| id | doaj.art-1aa1492b7fea4514aaec8598b788f2fe |
| institution | Directory Open Access Journal |
| issn | 2589-5370 |
| language | English |
| last_indexed | 2024-03-12T13:19:09Z |
| publishDate | 2023-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EClinicalMedicine |
| spelling | doaj.art-1aa1492b7fea4514aaec8598b788f2fe2023-08-26T04:44:00ZengElsevierEClinicalMedicine2589-53702023-09-0163102182Statin use and risk of colorectal cancer in patients with inflammatory bowel diseaseResearch in contextJiangwei Sun0Jonas Halfvarson1David Bergman2Fahim Ebrahimi3Bjorn Roelstraete4Paul Lochhead5Mingyang Song6Ola Olén7Jonas F. Ludvigsson8Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Corresponding author. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12A, Solna 171 65, Sweden.Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, SwedenDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, SwedenDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Gastroenterology and Hepatology, Clarunis - University Center for Gastrointestinal and Liver Diseases, Basel, SwitzerlandDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, SwedenMedicines Research Centre, GSK, Stevenage, UKDepartments of Epidemiology and Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA; Clinical and Translational Epidemiology Unit and Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USAClinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Sachs’ Children and Youth Hospital, Stockholm South General Hospital, Stockholm, Sweden; Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, SwedenDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Pediatrics, Örebro University Hospital, Örebro, Sweden; Division of Digestive and Liver Disease, Department of Medicine, Columbia University Medical Center, New York, NY, USASummary: 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 (1:1 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-control design: 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 (P for 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).http://www.sciencedirect.com/science/article/pii/S2589537023003590Inflammatory bowel diseaseStatinColorectal cancerCohort |
| spellingShingle | Jiangwei Sun Jonas Halfvarson David Bergman Fahim Ebrahimi Bjorn Roelstraete Paul Lochhead Mingyang Song Ola Olén Jonas F. Ludvigsson Statin use and risk of colorectal cancer in patients with inflammatory bowel diseaseResearch in context EClinicalMedicine Inflammatory bowel disease Statin Colorectal cancer Cohort |
| title | Statin use and risk of colorectal cancer in patients with inflammatory bowel diseaseResearch in context |
| title_full | Statin use and risk of colorectal cancer in patients with inflammatory bowel diseaseResearch in context |
| title_fullStr | Statin use and risk of colorectal cancer in patients with inflammatory bowel diseaseResearch in context |
| title_full_unstemmed | Statin use and risk of colorectal cancer in patients with inflammatory bowel diseaseResearch in context |
| title_short | Statin use and risk of colorectal cancer in patients with inflammatory bowel diseaseResearch in context |
| title_sort | statin use and risk of colorectal cancer in patients with inflammatory bowel diseaseresearch in context |
| topic | Inflammatory bowel disease Statin Colorectal cancer Cohort |
| url | http://www.sciencedirect.com/science/article/pii/S2589537023003590 |
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