Reduced Mortality Linked to Use of Statins in Patients With Colorectal Cancer
Statins for colorectal cancer associated with reduced colorectal cancer-specific mortality.
Statins, a class of medications commonly used to treat hyperlipidemia and prevent heart attacks and stroke, may benefit patients with colorectal cancer, a new study suggests.1
The study, “Statin Use After Colorectal Cancer Diagnosis and Survival: A Population-Based Cohort Study”, published in the Journal of Clinical Oncology, found that use of statins after a diagnosis of colorectal cancer was associated with reduced colorectal cancer-specific mortality.1
Based on a population of 7,657 patients who were recently diagnosed with stage 1 to stage 3 colorectal cancer, the study found a 29% reduction (fully adjusted hazard ratio, 0.71) in the rate of colorectal cancer-specific mortality in patients who took statins after their diagnosis.1
The researchers also observed a 21% reduction of colorectal cancer-specific mortality in patients who only used statins less than 1 year, while those who used statins for more than 1 year were observed to have a 35% reduction in their rate of cancer-specific mortality.1
Reductions in cancer-specific mortality were similar among all statins studied, including simvastatin, atorvastatin calcium, rosuvastatin, lovastatin, and pravastatin sodium.1 The researchers noted that “statins could have anticancer properties by inhibiting cell proliferation, including apoptosis, or inhibiting angiogenesis.”1
Statins may not only be beneficial in patients with colorectal cancer; statins used after diagnosis of prostate cancer may also decrease cancer-specific mortality, according to a study published in the Journal of Clinical of Oncology.2 In addition, a meta-analysis published in Clinical Gastroenterology and Hepatology found that statin use may be associated with a decreased risk of esophageal cancer, specifically in the risk of esophageal adenocarcinoma in patients with Barrett's esophagus.3
Another meta-analysis published in the European Journal of Clinical Pharmacology found that statins were associated with a reduced risk of developing gastric cancer.4 Despite the possible benefits of statins for patients with prostate and gastrointestinal cancers, a study published last year in Cancer, Epidemiology, Biomarkers, and Prevention found that patients who used statins for 10 years or more were nearly twice as likely to develop invasive ductal carcinoma or invasive lobular carcinoma.5
The use of statins has recently come under controversy, particularly after the American College of Cardiology/American Heart Association published their new lipid-lowering guidelines in late 2013.6 Some argue that these guidelines would lead to 45 million Americans receiving a prescription for a statin despite the possibility of the medication being medically unnecessary.7
If statins prove to be beneficial for decreasing mortality in patients with specific types of cancer or reducing the risk of developing cancer, even more patients could be prescribed statins as part of their cancer therapy, thereby increasing the risk of adverse effects associated with statins.
As with all medications, the benefits must outweigh the harm and future studies will have to establish whether statin use in patients with cancer trumps the possible adverse effects.
Statins inhibit 3-hydroxy-3-methylglutaryl-coenzyme (HMG-CoA) reductase, an enzyme used in the cholesterol-making process, thereby decreasing total cholesterol, low-density lipoproteins, and apolipoprotein B.8 Numerous statins on the market, including atorvastatin calcium, rosuvastatin, simvastatin, fluvastatin sodium, lovastatin, and pravastatin sodium, are used to lower cholesterol in patients with hyperlipidemia to reduce the risk of atherosclerotic events; however, they are also known for their adverse effects, like myopathy and hepatotoxicity, as well as their various drug interactions.
- Cardwell CR, Hicks BM, Hughes C, Murray LJ. Statin use after colorectal cancer diagnosis and survival: a population-based cohort study. J Clin Oncol. 2014 Aug 4. doi: 10.1200/JCO.2013.54.4569. [Epub ahead of print]
- Yu O, Eberg M, Benayoun S, et al. Use of statins and the risk of death in patients with prostate cancer. J Clin Oncol. 2014;32(1):5-11.
- Singh S, Singh AG, Singh PP, et al. Statins are associated with reduced risk of esophageal cancer, particularly in patients with Barrett's esophagus: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2013;11(6):620-629.
- Wu XD, Zeng K, Xue FQ, et al. Statins are associated with reduced risk of gastric cancer: a meta-analysis. Eur J Clin Pharmacol. 2013;69(10):1855-1860.
- McDougall JA, Malone KE, Daling JR, et al. Long-term statin use and risk of ductal and lobular breast cancer among women 55 to 74 years of age. Cancer Epidemiol Biomarkers Prev. 2013;22(9):1529-1537.
- Stone NJ, Robinson JG, Lichtenstein AH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;63(25 Pt B):2889-2934.
- Ridker PM, Cook NR. Statins: new American guidelines for prevention of cardiovascular disease. Lancet. 2013;382(9907):1762-1765.
- Lipitor® [package insert]. New York, NY: Pfizer, Inc. http://www.accessdata.fda.gov/drugsatfda_docs/label/2009/020702s056lbl.pdf.