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Use of Hypolipidemic Drugs and the Risk of Second Primary Malignancy in Colorectal Cancer Patients

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HALÁMKOVÁ Jana BOHOVICOVÁ Lucia PEHALOVÁ Lucie GONĚC Roman STANĚK Teodor KAZDA Tomáš MOUKOVÁ Lucie ADÁMKOVÁ KRÁKOROVÁ Dagmar KOZÁKOVÁ Šárka SVOBODA Marek DEMLOVÁ Regina KISS Igor

Rok publikování 2022
Druh Článek v odborném periodiku
Časopis / Zdroj Cancers
Fakulta / Pracoviště MU

Lékařská fakulta

Citace
www https://www.mdpi.com/2072-6694/14/7/1699
Doi http://dx.doi.org/10.3390/cancers14071699
Klíčová slova hypolipidemic agents; statins; second primary malignancies; second primary cancers; multiple primary neoplasms; colorectal cancer; cancer survivors
Popis Simple Summary Hypolipidemic drugs are among the most frequently prescribed medications in the Western world. Since many studies have indicated their role in carcinogenesis, this work aimed to investigate their association with the occurrence of a second primary malignancy in colorectal cancer survivors. The overall incidence of a second neoplasm was not linked to hypolipidemic medication; however, a subgroup analysis revealed a lower incidence of secondary neoplasia in statin users. When stratified by cancer types, a significant increase in gastric and bladder cancer was detected among colorectal cancer patients using hypolipidemic drugs. Survival outcomes in patients with early-stage colorectal carcinoma who suffered second cancer were significantly worse if treated with hypolipidemic drugs. Although our results do not provide evidence for a causative relationship between hypolipidemic medication and carcinogenesis, these correlations might steer the direction of tertiary prevention care towards specific risk factors shared between cardiovascular diseases and cancer. An increasing number of studies has brought evidence of the protective role of statin use against different types of cancer. However, data on their association with second primary malignancies (SPMs) are lacking. The purpose of this study was to determine the role of hypolipidemic treatment in the prevention of second primary cancer in colorectal cancer (CRC) survivors. We conducted a retrospective single-institution study of 1401 patients with newly diagnosed colorectal cancer from January 2003 to December 2016, with follow-up until December 2020. An SPM was detected in 301 patients (21%), and the incidence was significantly lower in patients with statin medication. However, stratification by cancer types revealed an increased incidence of bladder and gastric cancer in hypolipidemic users. A Kaplan-Meier analysis of early-stage CRC survivors with an SPM showed a significant survival benefit in patients without a history of hypolipidemic treatment. Despite the protective role of statins on overall second cancer incidence, these data indicate that CRC survivors treated with hypolipidemic drugs should be screened more cautiously for SPMs, especially for gastric and bladder cancer.
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