Does statin have a chemopreventive effect in patients with ulcerative colitis?

Yoon Suk Jung

doi:10.5217/ir.2025.00048

Articles

Page Path: HOME > Intest Res > Volume 23(2); 2025 > Article

Editorial IBD Does statin have a chemopreventive effect in patients with ulcerative colitis?: Yoon Suk Jung^,; Intestinal Research 2025;23(2):113-114.
DOI: https://doi.org/10.5217/ir.2025.00048
Published online: April 29, 2025

Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea

Correspondence to Yoon Suk Jung, Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Korea. E-mail: ys810.jung@samsung.com

• Received: March 25, 2025 • Accepted: March 31, 2025

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

292 Views
26 Download

Full Article

Download PDF

NOTES
REFERENCES

See the article "Risk of malignancies and chemopreventive effect of statin, metformin, and aspirin in Korean patients with ulcerative colitis: a nationwide population-based study" on page 129.

Many studies have suggested that statins may have chemopreventive potential against various cancers, beyond their cholesterol-lowering effects [1-7]. Inhibition of 3-hydroxy-3-methylglutaryl-coenzyme A reductase by statins leads to the reduced production of intermediates that contribute to carcinogenesis in the mevalonate pathway.1 Statins have been reported to have chemopreventive potential against cancer by inducing apoptosis, inhibiting tumor growth or angiogenesis, stimulating cellular immunity, and enhancing the anticancer effects of some cytokines [1].

Oh et al. [8] reported that after adjusting for age, sex, comorbidities, and ulcerative colitis (UC) treatment, statins showed a chemopreventive effect for all malignancies (adjusted hazard ratio [HR], 0.764; 95% confidence interval [CI], 0.645–0.905; P=0.002). Adjusted HRs for all malignancies decreased with a longer duration of statin use (duration ≤ 1 year, > 1–3 years, > 3–5 years, and > 5 years; adjusted HRs [95% CI] = 0.868 [0.704–1.069], 0.704 [0.549–0.904], 0.693 [0.504–0.954], and 0.627 [0.438–0.896]; P=0.009) [8].

The cancer most frequently suggested to be prevented by statins is colorectal cancer (CRC). A meta-analysis including 42 individual studies demonstrated a modest reduction in risk of CRC among statin users [1]. Recently, numerous studies have reported that statins may also have protective effects against various other types of cancer beyond CRC [2-7]. Meta-analysis studies, not individual studies, have revealed that statin use is associated with a reduced risk of pancreatic cancer [4], hepatocellular carcinoma [6], prostate cancer [2], gynecologic cancer [3], diffuse large B-cell lymphoma [5], and multiple myeloma [7]. However, these studies did not target inflammatory bowel disease. It may simply be thought that the cancer-preventive effect of statins observed in the general population can also be applied to patients with UC. However, patients with UC may have an increased risk of cancer due to the disease itself, such as an imbalance in immune regulation and chronic inflammatory state, as well as the use of drugs such as immunosuppressants and biologic agents [9]. Therefore, the cancer prevention effect of statins in patients with UC may differ from the results observed in the general population.

Oh et al.’s study suggests that statin use may also help prevent cancer in patients with UC. Oh et al.’s study showed that statins have a dose-dependent chemopreventive effect for all malignancies in patients with UC. However, unfortunately, the limited number of cases did not allow detailed analysis by each cancer type, except CRC. In this study, statin use tended to be associated with a lower risk of CRC, but the results were not statistically significant (adjusted HR, 0.844; 95% CI, 0.535–1.332; P=0.466). The number of cases may have been small to reach significant results for CRC. A recent meta-analysis including 2 studies reported that statin-exposed UC patients had a lower risk of CRC (odds ratio, 0.58; 95% CI, 0.46–0.73; P<0.001) [10]. However, no studies have evaluated the effects of statins on cancers other than CRC in patients with UC.

Although Oh et al.’s study suggests that statins may have beneficial effects on patients with UC, it would not be appropriate to recommend statin use for cancer prevention for all patients with UC. However, it may be necessary to regularly monitor cholesterol levels in these patients, and actively consider statin use if hypercholesterolemia is observed. Future large-scale studies including more patients will be needed to determine whether the cancers for which statins have been reported to have a preventive effect are also preventive in patients with UC, and whether statin use reduces lymphomas that may be associated with the use of immunosuppressants and biologic agents.

NOTES

Funding Source

The author received no financial support for the research, authorship, and/or publication of this article.

Conflict of Interest

Jung YS is an editorial board member of the journal but was not involved in the peer reviewer selection, evaluation, or decision process of this article. No other potential conflicts of interest relevant to this article were reported.

Data Availability Statement

Not applicable.

Author Contributions

Writing and approval of the final manuscript: Jung YS.

REFERENCES

1. Liu Y, Tang W, Wang J, et al. Association between statin use and colorectal cancer risk: a meta-analysis of 42 studies. Cancer Causes Control 2014;25:237–249.Article PubMed PDF
2. Cao Z, Yao J, He Y, et al. Association between statin exposure and incidence and prognosis of prostate cancer: a meta-analysis based on observational studies. Am J Clin Oncol 2023;46:323–334.PubMed PMC
3. Chen Y, Han L, Zheng A. Association between statin use and the risk, prognosis of gynecologic cancer: a meta-analysis. Eur J Obstet Gynecol Reprod Biol 2022;268:74–81.Article PubMed
4. Karbowska E, Swieczkowski D, Gasecka A, et al. Statins and the risk of pancreatic cancer: a systematic review and meta-analysis of 2,797,186 patients. Cardiol J 2024;31:243–250.Article PubMed PMC
5. Ponvilawan B, Charoenngam N, Ungprasert P. Association between statin use & risk of diffuse large B-cell lymphoma: a systematic review & meta-analysis. Indian J Med Res 2023;157:543–548.Article PubMed PMC
6. Tarar ZI, Farooq U, Inayat F, et al. Statins decrease the risk of hepatocellular carcinoma in metabolic dysfunction-associated steatotic liver disease: a systematic review and meta-analysis. World J Exp Med 2024;14:98543.Article PubMed PMC
7. Zhang P, Liu B. Statin use and the risk of multiple myeloma: a PRISMA-compliant meta-analysis. Ann Hematol 2020;99:1805–1812.Article PubMed PDF
8. Oh EH, Kim YJ, Kim M, Park SH, Kim TO, Park SH. Risk of malignancies and chemopreventive effect of statin, metformin, and aspirin in Korean patients with ulcerative colitis: a nationwide population-based study. Intest Res 2025;23:129–143.Article PubMed PDF
9. Na SY, Choi CH, Song EM, et al. Korean clinical practice guidelines on biologics and small molecules for moderate-to-severe ulcerative colitis. Intest Res 2023;21:61–87.Article PubMed PMC PDF
10. Li AJ, Jiang HY, Jia YH. Statin exposure and risk of colorectal cancer in patients with inflammatory bowel disease: a systematic review and meta-analysis. Front Med (Lausanne) 2024;11:1507739.Article PubMed PMC

Figure & Data

REFERENCES

Citations

Citations to this article as recorded by

PubReader
ePub Link

Cite

CITE: export Copy Download Format; Close

Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.