||5R01CA087709-05 Interpret this number
||Boston University Medical Campus
||Case Control Study of Statin Use and Large Bowel Cancer
DESCRIPTION (Adapted from applicant's abstract): Cancer of the large bowel is a
leading cause of cancer morbidity and mortality in the United States. Our
previous epidemiologic studies played a key role in documenting an inverse
association between the use of aspirin and other nonsteroidal anti-inflammatory
drugs (NSAIDS) and the incidence of large bowel cancer. Those studies were
inspired by laboratory data suggesting that NSAIDs may reduce colon
carcinogenesis. Now a growing body of laboratory data indicates that the
commonly used, relatively new class of cholesterol-lowering drugs, the
"statins" may have a similar chemopreventive potential: statins inhibit the
growth of colon cancer cells in vitro and in vivo. There is also some evidence
that statins may enhance the chemopreventive effect of NSAIDS. The statins
(e.g., lovastatin, simvastatin) were first marketed in 1987, and are now among
the most commonly prescribed drugs in the United States. At this time there is
little epidemiologic data concerning their potential protective effect against
large bowel cancer. Two randomized trials of statin use as preventives of
coronary heart disease had nonsignificant deficits of large bowel cancer in the
We propose to conduct a population-based case-control study in Massachusetts of
the relation of statin use to the risk of large bowel cancer. We will identify
2050 incident cases aged 50-74 through participating hospitals and 2050 age,
sex, and precinct matched community controls from Massachusetts town lists.
Cases and controls will be interviewed to obtain information on demographic
factors, risk factors for large bowel cancer, detailed histories of statin and
NSAID use, and data useful for addressing potential biases. The study is large
enough to assess the influence of characteristics of statin use (timing,
duration, dose) on the risk of large bowel cancer and to assess consistency of
findings across subgroups of age, sex, and cancer site. The joint effect of
statins and NSAIDs will also be assessed.
The proposed study will provide informative epidemiologic data on a potential
chemopreventive of large bowel cancer. Because the incidence of the disease and
prevalence of statin use by U.S. men and women are high, an inverse association
would be of considerable public health importance. Moreover, it would shed
light on a mechanism of colon carcinogenesis.
The use of folic acid antagonists and the risk of colorectal cancer.
, Rosenberg L.
Pharmacoepidemiology and drug safety, 2007 Oct; 16(10), p. 1111-9.
Statin use and risk of colorectal cancer.
, Smith J.
, Rosenberg L.
Journal of the National Cancer Institute, 2007-01-03; 99(1), p. 32-40.
Impact of a financial incentive on case and control participation in a telephone interview.
, Rosenberg L.
American journal of epidemiology, 2004-08-01; 160(3), p. 295-8.