Monday, July 30, 2007

 

statins colon cancer

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Statins May Cut Colon Cancer Recurrence

Allison Gandey

Medscape Medical News 2007. © 2007 Medscape

July 26, 2007 (Chicago) — Researchers report that statins decreased the risk for recurrence in patients diagnosed with stage 1, 2, or 3 colon cancer. Presenting at the recent American Society of Clinical Oncology (ASCO) 43rd Annual Meeting, investigators say the popular lipid-lowering agents may have an important role to play in patients with resected disease.

"Just 6 of 89 patients (6.7%) treated with any statin relapsed, as opposed to 43 of 269 (16%) patients with no statin use," lead author Daniel Anderson, MD, from Regions Hospital, in St. Paul, Minnesota, said during his presentation. The Fisher’s exact test resulted in a P value of .03. Kaplan-Meier analysis of relapse curves showed a significant difference in relapse between groups, with a 2-year recurrence rate of 3.7% among statin users and 10.1% among nonusers (log rank P = .03, using age stratification).

The investigators reported that a significant body of research suggests that statin use reduces the risk of developing colon and other cancers. But not all studies have confirmed these findings. As reported by Medscape earlier this week, a study published in the July 31 issue of the Journal of the American College of Cardiology suggests the cardiovascular benefits of achieved levels of low-density lipoprotein cholesterol might be offset by an increased risk for cancer. In the analysis of patients enrolled in large, randomized statin trials, investigators observed a significant and linear relationship between target cholesterol levels and the risk for new cancer cases.

In the study reported at ASCO, Dr. Anderson, working with colleagues from the Health Partners Research Foundation, in Bloomington, Minnesota, conducted a retrospective analysis of patients treated for stage 1, 2, or 3 colon cancer.

Patients were identified through a hospital tumor registry. All cases were then crosschecked against a health maintenance organization (HMO) membership database. Information on statin use was obtained from the HMO outpatient pharmacy database.

Could Lipid-Lowering Agents Play a Role in Resected Disease?

For each patient, investigators obtained all available data from a 5-year period before first diagnosis of cancer until recurrence or most recent documentation. Dr. Anderson and his team combined demographic and survival data from the tumor registry with pharmacy data on statin use. The researchers then analyzed recurrence and time to recurrent disease in statin users and nonusers.

They looked at 358 colon cancer cases. The median follow-up of patients after diagnosis of colon cancer was 49 months. A total of 89 patients (24.9%) used statins for some period of time, with a median of 780 days of use. The median age of all patients enrolled was 69 years (range, 24 – 95 years).

Statin use was higher in older patients. Those aged 61 to 75 years (33%) were more likely to be taking lipid-lowering agents than those aged 24 to 60 years (22%). But older patients were also more likely to be taking statins than their elderly counterparts — those aged 76 to 95 years (19%) (P = .02).

The researchers found that statin use was linked to a reduced risk for colon cancer recurrence. They observed no association between statin use and stage at diagnosis. But Dr. Anderson cautioned, "Further study of statin use in the prevention of colon cancer recurrence is warranted."

American Society of Clinical Oncology 43rd Annual Meeting: Abstract 4114. Presented June 4, 2007.



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