Statins and the Risk of Colorectal Cancer

Statins and the Risk of Colorectal Cancer: A Meta-Analysis of 18
Studies Involving More Than 1.5 Million Patients

Journal of Clinical Oncology, Vol 25, No 23 (August 10), 2007: pp.
3462-3468

Stefanos Bonovas, Kalitsa Filioussi, Christodoulos S. Flordellis,
Nikolaos M. Sitaras

From the Department of Pharmacology, School of Medicine, University of
Athens; Center for Disease Control and Prevention, Athens; and the
Department of Pharmacology, School of Medicine, University of Patras,
Patras, Greece

Address reprint requests to Stefanos Bonovas, MD, MSc, Department of
Pharmacology, School of Medicine, University of Athens, 75 Mikras
Asias Str, Athens 11527, Greece; e-mail: sbonovas@xxxxxxxxxx

Purpose: Statins have been suggested to prevent colorectal cancer.
Several epidemiologic studies have evaluated this association, whereas
randomized controlled trials (RCTs) on cardiovascular outcomes provide
relevant data as a secondary end point. Our aim was to examine the
strength of this association through a detailed meta-analysis of the
studies published on the subject in peer-reviewed literature.

Methods: A comprehensive search for studies published up to December
2006 was performed, reviews of each study were conducted, and data
were abstracted. Before meta-analysis, the studies were evaluated for
publication bias and heterogeneity. Pooled relative risk (RR)
estimates with 95% CIs were calculated using the fixed- and random-
effects models.

Results: Eighteen studies involving more than 1.5 million participants
contributed to the analysis. They were grouped on the basis of study
design, and separate meta-analyses were conducted. There was no
evidence of an association between statin use and risk of colorectal
cancer either among RCTs (RR = 0.95; 95% CI, 0.80 to 1.13; n = 6) or
among cohort studies (RR = 0.96; 95% CI, 0.84 to 1.11; n = 3).
However, statin use was associated with a modest reduction in the risk
of colorectal cancer among case-control studies (RR = 0.91; 95% CI,
0.87 to 0.96; n = 9). Low evidence of publication bias or
heterogeneity was found.

Conclusion: Our meta-analysis results do not support the hypothesis
that statins strongly reduce the risk of colorectal cancer, when taken
for management of hypercholesterolemia. However, we cannot rule out a
modest reduction in risk or an effect associated with higher doses of
statins.

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