Prospective Analysis of Association Between Use of Statins or Other Lipid-Lowering Agents and Colorectal Cancer Risk

Title: Statins use and colorectal cancer risk

Running head: statins and colorectal cancer

Shih-Wei Lai, MD1,2_{; Kuan-Fu Liao, MD and MS}3,4,5

1_{School of Medicine, and} 3_{Graduate Institute of Integrated Medicine, China Medical} University, Taichung, 404, Taiwan

2_{Department of Family Medicine, China Medical University Hospital, Taichung, 404,} Taiwan

4_{Department of Internal Medicine, Taichung Tzu Chi General Hospital, Taichung,} 427, Taiwan

5_{Department of Health Care Administration, Central Taiwan University of Science} and Technology, Taichung, 406, Taiwan

Corresponding author: Kuan-Fu Liao, MD and MS

Department of Internal Medicine, Taichung Tzu Chi General Hospital, No.66, Sec. 1, Fongsing Rd., Tanzi District, Taichung City, 427, Taiwan

Phone: 886-4-2205-2121 Fax: 886-4-2203-3986

E-mail: kuanfuliao@yahoo.com.tw

Conflict of Interest Statement: The authors disclose no conflicts of interest.

To the editor,

Simon and colleagues in a report published in the Annals of Epidemiology observed that women that took lovastatin (a lipophilic statin) had a 38% risk reduction for colorectal cancer (95% CI = 0.39-0.99) . Similarly, we recently published a study that showed that taking fluvastatin (a lipophilic statin ) for more than six months was associated with a decreased risk for colorectal cancer (odds ratio = 0.61, 95% CI = 0.42-0.90). The findings of Simon et al as well as our own, highlight the structural differences of statins and their effect on colorectal cancer risk.

Recently, Lochhead and colleagues reported on whether statins could be used for chemoprevention of colorectal cancer and found that the existing data did not support such use. Nevertheless, an in vitro study has shown that the effects of statins on colorectal cancer are mediated by underlying molecular mechanisms (4) and this is one reason why studies on statin use associated with colorectal cancer have not shown consistent results(5). That is, some studies have demonstrated a protective effect, but others have shown harmful effects of statins on colorectal cancer risk. Therefore, the effect of statins on colorectal cancer risk remains undetermined. Additional prospective studies on statins use with a focus on the individual underlying molecular subtypes are needed to elucidate this issue.

REFERENCES

1. Simon MS, Rosenberg CA, Rodabough RJ, et al. Prospective analysis of association between use of statins or other lipid-lowering agents and colorectal cancer risk. Ann Epidemiol 2012;22(1):17-27.

2. Lai SW, Liao KF, Lai HC, et al. Individual statins on the risk of colorectal cancer: a population-based observation in Taiwan. Kuwait Med J

2012;44(3):255-6.

3. Lochhead P, Chan AT. Statins and Colorectal Cancer. Clin Gastroenterol

Hepatol 2012(online paper).

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through the bone morphogenetic protein pathway. Gastroenterology 2007;133 (4): 1272-81.

5. Jacobs RJ, Kodach LL, Hardwick JC. The potential of statins for individualized colorectal cancer chemoprevention. Curr Drug Targets 2011;12 13): 1903-8.