Statins may reduce the risk of colorectal cancer
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《英国医生杂志》
Taking statins for at least five years reduced the relative risk of colorectal cancer by 47%, a large study has shown.
The retrospective, case controlled study was conducted in northern Israel by epidemiologists at the Technion-Israel Institute of Technology抯 Medical School and Clalit Health Services National Cancer Control Centre in Haifa and published in the latest issue of the New England Journal of Medicine (2005;352:2184-92). An accompanying editorial by physicians at the US National Cancer Institute advocates immediate prospective studies to confirm the findings.
The team, led by Professor Gad Rennert, head of the Clalit Health Services National Cancer Registry and Professor Stephen Gruber of the University of Michigan, compared 1953 patients with colorectal cancer and 2015 control patients without colorectal cancer. Use of statins for at least five years was reported by 120 patients (6.1%) in the cancer group and 234 patients (11.6%) in the control group (odds ratio 0.50 (95% confidence interval 0.40 to 0.63).
Most of the patients were Jews of Ashkenazi origin, a group in which colorectal cancer is common, but both groups included Jews of Sephardi origin and Arabs. Adjustments were made for age, sex, the use or non-use of aspirin or other non-steroidal anti-inflammatory drugs, ethnic group, first degree history of colorectal cancer, vegetable consumption, exercise, and hypercholesterolaemia.
Several randomised clinical trials in the past that aimed to assess the safety of statins and cardiovascular outcomes also looked at the incidence of cancer, but their results were not consistent.
The researchers in the latest study suggest, on the basis of in vitro studies, that hydroxymethyl glutaryl coenzyme A reductase is overexpressed in colorectal cancer cells. Thus statins, which inhibit this enzyme, potentially have chemopreventive effects against cancer, they wrote.
The authors estimated that given that the rate of colorectal cancer is 42 per 100,000 Jewish men in Israel, and similar among women, it would be necessary to treat 4814 persons with statins in order to prevent one case of colorectal cancer.
The editorial said it was too early to recommend statins as chemopreventive agents against colorectal cancer outside the context of clinical trials and urged prospective clinical trials looking at treatment.(Jerusalem Judy Siegel-Itzkovich)
The retrospective, case controlled study was conducted in northern Israel by epidemiologists at the Technion-Israel Institute of Technology抯 Medical School and Clalit Health Services National Cancer Control Centre in Haifa and published in the latest issue of the New England Journal of Medicine (2005;352:2184-92). An accompanying editorial by physicians at the US National Cancer Institute advocates immediate prospective studies to confirm the findings.
The team, led by Professor Gad Rennert, head of the Clalit Health Services National Cancer Registry and Professor Stephen Gruber of the University of Michigan, compared 1953 patients with colorectal cancer and 2015 control patients without colorectal cancer. Use of statins for at least five years was reported by 120 patients (6.1%) in the cancer group and 234 patients (11.6%) in the control group (odds ratio 0.50 (95% confidence interval 0.40 to 0.63).
Most of the patients were Jews of Ashkenazi origin, a group in which colorectal cancer is common, but both groups included Jews of Sephardi origin and Arabs. Adjustments were made for age, sex, the use or non-use of aspirin or other non-steroidal anti-inflammatory drugs, ethnic group, first degree history of colorectal cancer, vegetable consumption, exercise, and hypercholesterolaemia.
Several randomised clinical trials in the past that aimed to assess the safety of statins and cardiovascular outcomes also looked at the incidence of cancer, but their results were not consistent.
The researchers in the latest study suggest, on the basis of in vitro studies, that hydroxymethyl glutaryl coenzyme A reductase is overexpressed in colorectal cancer cells. Thus statins, which inhibit this enzyme, potentially have chemopreventive effects against cancer, they wrote.
The authors estimated that given that the rate of colorectal cancer is 42 per 100,000 Jewish men in Israel, and similar among women, it would be necessary to treat 4814 persons with statins in order to prevent one case of colorectal cancer.
The editorial said it was too early to recommend statins as chemopreventive agents against colorectal cancer outside the context of clinical trials and urged prospective clinical trials looking at treatment.(Jerusalem Judy Siegel-Itzkovich)