Journal of Clinical Oncology, 2004 ASCO Annual Meeting Proceedings (Post-Meeting Edition).
Vol 22, No 14S (July 15 Supplement), 2004: 1
© 2004 American Society of Clinical Oncology

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Abstract

HMG CoA reductase inhibitors and the risk of colorectal cancer

University of Michigan, Ann Arbor, MI; CHS National Cancer Control Center, Haifa, Israel

1

Background: 3-hydroxy-2-methylglutaryl coenzyme A (HMG CoA) reductase inhibitors are effective lipid-lowering agents that also inhibit the growth of colon cancer cell lines and were noted to be associated with a reduced risk of colorectal cancer (CRC) in a randomized clinical trial of patients with myocardial infarction. We investigated the association between HMG CoA reductase inhibitors and CRC in a population-based case-control study of incident CRC. Methods: The Molecular Epidemiology of Colorectal Cancer Study (MECC) is a study of 1608 CRC cases diagnosed in northern Israel between 1998 and 2002, and 1734 population-based controls matched for age, gender, and ethnicity. Subjects participated in an interview which assessed personal and family history of cancer, screening practices, other medical conditions, medication use, physical activity, and nutritional data including a food frequency questionnaire. Diagnosis of colorectal cancer was confirmed by standardized pathology review. Use of HMG CoA reductase inhibitors was measured by self report as a dichotomous variable with a minimum duration of five years of use. Results: Use of HMG CoA reductase inhibitors was reported by 267/3342 subjects in the MECC study (7.99%). The unadjusted odds ratio for use of any HMG CoA reductase inhibitor had a significantly protective effect with an odds ratio of 0.46 (95% CI 0.35–0.60). This association remained unchanged (OR 0.49, 95% CI 0.36–0.68) after adjustment for age, hypercholesterolemia, ethnicity, aspirin or NSAID use, and the low penetrance susceptibility allele, APC I1307K. To assess whether the association was the result of a non-specific cholesterol lowering effect, we also looked at other cholesterol-lowering drugs and found no significant association between bezafibrate and CRC (OR 1.08, 95% CI 0.56–2.08). Conclusions: HMG CoA reductase inhibitors are associated with a 51% reduction in the risk of colorectal cancer, and the protective effect is specific to this class of lipid-lowering agents. The significant protective effect of HMG CoA reductase inhibitors in CRC indicates that these drugs deserve further investigation in chemoprevention and therapeutic clinical trials.

No significant financial relationships to disclose.

Abstract presentation from the 2004 ASCO Annual Meeting