长期服用他汀类药物或增加大肠癌风险
创作:aluba 审核:aluba 2021年11月13日
  • 纳入100,300名女性及47,991名男性受试者,最多24年的随访期间,发生2,924例结直肠癌;
  • 更长的他汀类药物使用时间与更高的结肠癌(而非直肠癌)风险相关;
  • 与未使用过他汀类药物的受试者相比,使用他汀类药物超过15年的受试者的结肠癌风险显著增加(HR=1.85);
  • 进一步分析结果显示,他汀类药物使用时长与近端结肠癌(而非远端结肠癌)的风险增加显著相关;
  • 总胆固醇水平与结直肠癌风险无显著关联。
主编推荐语
aluba
他汀类药物被认为可能有助于预防结肠癌。然而,American Journal of Gastroenterology上发表的一项前瞻性队列研究,在分析近15万名受试者超过20年的随访数据后发现,更长的他汀类药物使用时间与更高的结肠癌(尤其是近端结肠癌)风险相关,而总胆固醇水平与结直肠癌风险无显著关联。
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Long-Term Statin Use, Total Cholesterol Level, and Risk of Colorectal Cancer: A Prospective Cohort Study

长期他汀使用及总胆固醇水平与结直肠癌风险:前瞻性队列研究

10.14309/ajg.0000000000001543

2021-11-03, Article

Abstract & Authors:展开

Abstract:收起
INTRODUCTION: Statin use has been examined as a potential chemopreventive strategy against colorectal cancer (CRC). Previous studies have not been able to investigate this topic with adequate follow-up time or disentangle the effects of statin use and total cholesterol level. We investigated prospectively this topic.
METHODS: Eligible participants (100,300 women and 47,991 men) in the Nurses' Health Study and Health Professionals Follow-Up Study were followed for up to 24 years. Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals.
RESULTS: We documented 2,924 incident CRC cases during follow-up. In fully adjusted analyses, longer duration of statin use was associated with higher risk of colon cancer (hazard ratios, the 95% confidence interval was 1.09, 0.95-1.25 for 1-5 years; 1.16, 0.99-1.36 for 6-10 years; 1.08, 0.81-1.44 for 11-15 years; 1.85, 1.30-2.61 for >15 years; vs never users, P = 0.004 for trend) rather than rectal cancer. The risk elevation was driven by proximal colon cancer (1.16, 0.98-1.38 for 1-5 years; 1.19, 0.98-1.45 for 6-10 years; 1.25, 0.89-1.74 for 11-15 years; 2.17, 1.46-3.24 for >15 years; vs never users, P = 0.001 for trend) rather than distal colon cancer. The results remained robust in analyses among participants with hypercholesterolemia or who never received screening. Total cholesterol level was not associated with CRC risk.
DISCUSSION: This study does not support benefit of statin use in CRC chemoprevention or any association between total cholesterol level and CRC risk. On the contrary, long-term statin use may be associated with increased colon cancer risk (driven by proximal colon cancer).

First Authors:
Yin Zhang

Correspondence Authors:
Edward L Giovannucci

All Authors:
Yin Zhang,Kana Wu,Andrew T Chan,Jeffrey A Meyerhardt,Edward L Giovannucci

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