Coogan Patricia F, Smith Jacquelyn, Rosenberg Lynn
Slone Epidemiology Center, Boston University School of Medicine, 1010 Commonwealth Ave., Boston, MA 02215, USA.
J Natl Cancer Inst. 2007 Jan 3;99(1):32-40. doi: 10.1093/jnci/djk003.
Statins have anticancer activity in various cell types, including colon cancer cells. Although epidemiologic data on the relationship between statin use and the risk of colorectal cancer are limited, one case-control study reported a 50% reduction in colorectal cancer risk among statin users. We conducted a population-based case-control study to assess this association with respect to statin type, dose, and duration of use.
Case patients with adenocarcinoma of the colon or rectum were ascertained from participating hospitals in Massachusetts and the Massachusetts Cancer Registry from January 1, 2001, through November 30, 2004. Age-, sex-, and precinct-matched control subjects were chosen from Massachusetts town lists. Information on statin use and other relevant data were obtained by telephone interview. We used multivariable conditional logistic regression models to estimate odds ratios (ORs). All tests for statistical significance were two-sided.
Among 1809 case patients and 1809 matched control subjects, regular use of statins for at least 3 months was not associated with the risk of colorectal cancer (OR = 0.92, 95% confidence interval [CI] = 0.78 to 1.09). There was no consistent trend across dose or duration of use (e.g., for > or = 10 years of use, OR = 0.86, 95% CI = 0.51 to 1.45). The risk of stage IV cancer was, however, statistically significantly lower among statin users than among nonusers (OR = 0.49, 95% CI = 0.26 to 0.91). There was no evidence of an interaction between statin use and nonsteroidal anti-inflammatory drug use.
Overall, use of statins did not appear to be associated with reduced risk of colorectal cancer. The reduced risk of stage IV cancer observed among statin users requires confirmation.
他汀类药物在包括结肠癌细胞在内的多种细胞类型中具有抗癌活性。尽管关于他汀类药物使用与结直肠癌风险之间关系的流行病学数据有限，但一项病例对照研究报告称，他汀类药物使用者的结直肠癌风险降低了50%。我们进行了一项基于人群的病例对照研究，以评估他汀类药物类型、剂量和使用持续时间与这种关联的关系。
2001年1月1日至2004年11月30日期间，从马萨诸塞州的参与医院和马萨诸塞州癌症登记处确定患有结肠或直肠癌腺癌的病例患者。年龄、性别和选区匹配的对照受试者从马萨诸塞州城镇名单中选取。通过电话访谈获取他汀类药物使用情况及其他相关数据。我们使用多变量条件逻辑回归模型来估计比值比（OR）。所有统计学显著性检验均为双侧检验。
在1809例病例患者和1809例匹配对照受试者中，规律使用他汀类药物至少3个月与结直肠癌风险无关（OR = 0.92，95%置信区间[CI] = 0.78至1.09）。在剂量或使用持续时间方面没有一致的趋势（例如，使用≥10年，OR = 0.86，95% CI = 0.51至1.45）。然而，他汀类药物使用者中IV期癌症的风险在统计学上显著低于非使用者（OR = 0.49，95% CI = 0.26至0.91）。没有证据表明他汀类药物使用与非甾体抗炎药使用之间存在相互作用。
总体而言，使用他汀类药物似乎与降低结直肠癌风险无关。他汀类药物使用者中观察到的IV期癌症风险降低需要进一步证实。
