TY - JOUR
T1 - Statin use and site-specific risk of colorectal cancer in individuals with hypercholesterolemia from the National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS)
AU - Lee, Jae Woo
AU - You, Na Young
AU - Kim, Yeseul
AU - Kim, Yonghwan
AU - Kim, Joungyoun
AU - Kang, Hee Taik
N1 - Publisher Copyright:
© 2019 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University
PY - 2019/7
Y1 - 2019/7
N2 - Background and aims: We investigated the association between statin use and site-specific risk of colorectal cancer in individuals with hypercholesterolemia. Methods and results: This study is based on the National Health Insurance Service-National Health Screening Cohort, conducted during 2002–2015. Statin users were classified as high and low users according to medication possession ratio (MPR). Statin nonusers comprised participants who did not use statins during the entire follow-up period. In total, 17,737 statin users and 13,412 statin nonusers were included in the analysis, with a median follow-up period of 12.7 years. Cox proportional hazards regression models were adopted after stepwise adjustment for confounders to investigate prospective association between statin usage and colorectal cancer risk. In total, 378 (2.3%) of 16,588 male participants and 239 (1.6%) of 14,561 female participants had colorectal cancer during the follow-up period. Compared to nonusers, fully adjusted hazard ratios (HRs) (95% confidence intervals [95% CIs]) for colorectal cancer risk in high statin users were 0.56 (0.42–0.75) in men and 0.64 (0.46–0.90) in women. In men, the fully adjusted HRs for proximal and rectal cancer for high users were 0.29 (0.15–0.56) and 0.52 (0.35–0.78), respectively, compared to those for nonusers. In women, statistical significance was seen only in rectal cancer (HR 0.43 [0.25–0.72]) but not in proximal or distal colon cancer. Conclusions: High statin users with hypercholesterolemia were associated with lower risk of overall colorectal cancer, especially proximal colon cancer in men and rectal cancer in both sexes.
AB - Background and aims: We investigated the association between statin use and site-specific risk of colorectal cancer in individuals with hypercholesterolemia. Methods and results: This study is based on the National Health Insurance Service-National Health Screening Cohort, conducted during 2002–2015. Statin users were classified as high and low users according to medication possession ratio (MPR). Statin nonusers comprised participants who did not use statins during the entire follow-up period. In total, 17,737 statin users and 13,412 statin nonusers were included in the analysis, with a median follow-up period of 12.7 years. Cox proportional hazards regression models were adopted after stepwise adjustment for confounders to investigate prospective association between statin usage and colorectal cancer risk. In total, 378 (2.3%) of 16,588 male participants and 239 (1.6%) of 14,561 female participants had colorectal cancer during the follow-up period. Compared to nonusers, fully adjusted hazard ratios (HRs) (95% confidence intervals [95% CIs]) for colorectal cancer risk in high statin users were 0.56 (0.42–0.75) in men and 0.64 (0.46–0.90) in women. In men, the fully adjusted HRs for proximal and rectal cancer for high users were 0.29 (0.15–0.56) and 0.52 (0.35–0.78), respectively, compared to those for nonusers. In women, statistical significance was seen only in rectal cancer (HR 0.43 [0.25–0.72]) but not in proximal or distal colon cancer. Conclusions: High statin users with hypercholesterolemia were associated with lower risk of overall colorectal cancer, especially proximal colon cancer in men and rectal cancer in both sexes.
KW - Colon
KW - HMG CoA reductase inhibitors
KW - Hypercholesterolemia
KW - Kaplan-Meier estimate
KW - Malignant neoplasms
KW - Rectum
UR - http://www.scopus.com/inward/record.url?scp=85066090843&partnerID=8YFLogxK
U2 - 10.1016/j.numecd.2019.04.002
DO - 10.1016/j.numecd.2019.04.002
M3 - Article
C2 - 31133496
AN - SCOPUS:85066090843
SN - 0939-4753
VL - 29
SP - 701
EP - 709
JO - Nutrition, Metabolism and Cardiovascular Diseases
JF - Nutrition, Metabolism and Cardiovascular Diseases
IS - 7
ER -