Case-Control Study of Statin Use and Large Bowel Cancer (C2K)

Objectives

This study’s object was to assess whether the use of the cholesterol-lowering drugs, the statins (e.g., Lipitor), reduces the risk of large bowel cancer. Laboratory evidence indicates that the statins inhibit the growth of colon cancer cells, an effect that may be enhanced by nonsteroidal anti-inflammatory drugs (NSAIDs). Because both the incidence of large bowel cancer and the prevalence of statin use are high in the United States, a protective effect of statin use would be of considerable public health importance.

Methods

In this population-based Massachusetts study, incident cases of primary adenocarcinoma of the colon or rectum were ascertained through the tumor registrars of participating hospitals and the Massachusetts Cancer Registry. Controls matched to the cases on age, sex, and precinct of residence were chosen from Massachusetts town lists. Cases and controls who agreed to participate were administered a questionnaire over the telephone about medical history, lifestyle habits, and use of statins and other selected medications. Participants also completed a diet questionnaire. The analyses assessed the effect of statin use, alone and in combination with NSAIDs, on the risk of large bowel cancer.

Results

Among 1809 case patients and 1809 matched control subjects, the regular use of statins for at least 3 months was not associated with the risk of colorectal cancer (odds ratio = 0.92, 95% confidence interval = 0.78 to 1.09). There was no consistent trend across dose or duration of use. The risk of stage IV cancer was statistically significantly lower among statin users than among nonusers (OR = 0.49, 95% CI = 0.26 to 0.91). There was no evidence of 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.

Investigators and Study Staff

Patricia F. Coogan, Sc.D., Principal Investigator
Lynn Rosenberg, Sc.D., Co-Investigator

Study Details

Source of Funding:

National Cancer Institute

Study Period:

September 1, 2000 to August 31, 2005

Publications

  • Coogan PF, Smith JA, Rosenberg L.  Statin use and risk of colorectal cancer.  J Natl Cancer Inst 2007;99(1):32-40.
  • Coogan PF, Rosenberg L. Impact of a financial incentive on case and control participation in a telephone interview. Am J Epidemiol 2004;160:295-8.