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Does Statin Use Increase Overall Survival in Patients With Colorectal Cancer?


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About 40 million adults in the United States take a statin to lower their cholesterol and reduce the risk for heart disease—but they may also be getting an added anticancer benefit, a growing body of evidence suggests. According to research presented at the American Heart Association’s Scientific Sessions conference in 2019 and published by Melloni et al in Circulation, statin use at the time of colorectal cancer diagnosis is associated with improved overall survival.

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Findings

Researchers analyzed the medical records of 29,498 veterans who had been diagnosed with colorectal cancer at a VA Medical Center from 2001 to 2011. They defined statin users as patients who had two or more prescription fills within 6 months relative to their colorectal cancer diagnosis. Thirty-eight percent of patients were identified as statin users.

After about 5 years of follow-up, those taking a statin at the time of their cancer diagnosis were 31% less likely to die from any cause and 38% less likely to die from colorectal cancer than those not taking the medication. The 10-year overall survival rate was 40% for statin users vs 34% for those not on statins (P < .001) and the cancer-specific survival rate was 68% vs 56% (P < .001). Statin use at time of diagnosis was associated with a reduction in all-cause mortality, and survival benefits were consistent when stratified by age at diagnosis, race, tumor location, disease stage, or presence of cardiovascular comorbidities.

“The preliminary findings confirm that statins can have a benefit in overall survival for colorectal cancer patients,” said first study author Chiara Melloni, MD.

Commentary

Ronac Mamtani, MD, MSCE, an oncologist at the University of Pennsylvania Perelman School of Medicine who was not involved with the research, said these latest findings are similar to other studies in breastprostate and colorectal cancer that show statin users have better outcomes.

KEY POINTS

  • After about 5 years of follow-up, those taking a statin at the time of their cancer diagnosis were 31% less likely to die from any cause and 38% less likely to die from colorectal cancer than those not taking the medication.
  • The 10-year overall survival rate was 40% for statin users vs 34% for those not on statins and the cancer-specific survival rates was 68% vs 56% (P < .001).
  • Statin use at time of diagnosis was associated with a reduction in all-cause mortality, and survival benefits were consistent when stratified by age at diagnosis, race, tumor location, disease stage, or presence of cardiovascular comorbidities.

What he called particularly striking about the new study was that statins appeared to better protect against colorectal cancer death than the medication protected against having a heart attack or stroke. Being on a statin lowered the risk of heart attack by 9% and stroke by 23%, compared to the nearly 40% reduction in death from colorectal cancer.

Dr. Melloni said her team intends to analyze their data further to see whether specific statins or statin doses resulted in better outcomes. The team also will look at whether the reason for taking a statin—either to prevent heart disease or to treat it—factored into the results.

The best test for the statin/cancer connection would be a clinical trial that randomly assigns healthy people to a statin or a placebo and then follows them to see if those on the statin are less likely to develop cancer or live longer after a cancer diagnosis than those on the placebo.

Such a study “can help us see who might really benefit,” concluded Dr. Melloni.

Disclosure: For full disclosures of the study authors, visit ahajournals.org.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
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