During the study period there were 25 811 CRC cases which were matched by making love, age at time of index date (5 years), and healthcare region to 129 117 regulates
During the study period there were 25 811 CRC cases which were matched by making love, age at time of index date (5 years), and healthcare region to 129 117 regulates. CRC between 2010 and 2015 and 129 117 frequency-matched settings. Subjects were classified as exposed to statins if they had ever been dispensed statins. Analysis considering mean daily defined dose, cumulative duration and type of statin were performed. Overall, 66 372 subjects (43%) were exposed to statins. There was no significant decrease of CRC risk connected to any statin exposure (OR?=?0.98; 95% CI: 0.95C1.01). Only in the stratified analysis by location a reduction of risk for rectal malignancy was observed connected to statin exposure (OR?=?0.87; 95% CI: 0.81C0.92). This study does not support an overall protecting effect of statins in CRC, but a protecting association with rectal malignancy merits further study. strong class=”kwd-title” Subject terms: Disease prevention, Epidemiology, Colorectal malignancy, Risk factors Intro Colorectal malignancy (CRC) is the third most common malignancy worldwide1 and its TAK-071 incidence is still rising in many low and middle income countries2. Focus on main prevention and screening is necessary in order to reduce the incidence and mortality of this tumor. Although KIR2DL5B antibody life-style risk factors have been TAK-071 recognized in CRC3, randomized tests possess failed to display a reduction of adenomas recurrence with diet4C6 or diet health supplements7,8. A large body of evidence has shown that nonsteroidal anti-inflammatory medicines (NSAID), particularly acetylsalicylic acid (ASA), reduce the risk of colorectal neoplasia9,10 but with possible adverse events11. Indeed, a safe and effective CRC chemoprevention agent in average-risk human population would help reducing the incidence of colorectal neoplasia. Statins, inhibitors of 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase, are a widely used and well-tolerated class of medicines for the treatment of hypercholesterolemia. Previous studies show their possible role in malignancy chemoprevention12,13, with controversial results14C16. In addition to their main effect on cholesterol synthesis, statins may cause a number of additional pleiotropic effects that may influence tumorigenesis, such as antioxidant activity, effects on cell adhesion, or angiogenesis17. em In vitro /em , statins have shown anti-proliferative and pro-apoptotic effects on human being CRC cell lines, and also in tumour xenograft models18,19. Studies analysing the effects of exposure to statins within the prevention or prognosis of colorectal neoplasia have shown controversial results, which have been proposed to be due to heterogeneity amongst medicines, or to effects restricted to some subgroup of individuals14C16,20. With this observational study we have analysed a population-based health records database aiming to examine the association between statins, their subtypes and pattern of use, and CRC risk. Methods Data source Subjects were selected from the Information System for Development of Primary Care Research (SIDIAP) database (www.sidiap.org)21, which comprises clinical info routinely collected by main care professionals of the Catalan Institute of Health. This database includes info from 5.8 million people in Catalonia (almost 80% of the population) that have ever contacted the public health system since 2005. The data retrieved included routine clinical data, such as diagnoses and health measurements, and was linked to info on dispensed prescriptions generated by pharmacies statements for reimbursement from the Catalan Health System. Drugs were coded according to the Anatomical Restorative Chemical (ATC) classification system22, and the day and quantity of the drug withdrawn from your pharmacy were recorded. Irreversible encoding of patient identifiers guaranteed anonymization of the information in the SIDIAP study database. The quality of SIDIAP data has been previously recorded, and it has been used to study the epidemiology of health results23. All methods performed in the study including data from human being participants were in accordance with the ethical requirements of the institutional study committee, and with the 1964 Helsinki Declaration and its later on amendments TAK-071 or similar ethical requirements. No educated consent was requested to the participating individuals, since this study was based on anonymized data regularly collected. No variables with potential to identify specific individuals were retrieved. The study protocol was authorized by the Ethics Committee for Clinical Study of IDIAP Jordi Gol and all relevant regulatory requirements were fulfilled. The study was authorized in ENCePP database with code EUPAS12697. Study design A population-based case-control study nested within the cohort of subjects receiving main care from your Institut Catal de la Salut was carried out. The flow chart of the study is explained in Fig.?1. The cohort of subjects authorized in SIDIAP with at least one healthcare connection in last 3 years (n?=?5 830 562) was limited to adult population, aged 18 to 90 years (n?=?4 664 450). Instances recognized with a recorded incident analysis of colon or rectum (codes C18, C19, and C20 of the International Classification of Diseases 10th Revision [ICD-10]) within the period January 1, 2010 TAK-071 to December 31, 2015 were recognized. Those cases having a TAK-071 analysis of appendix malignancy (C18.1).