Abstract
BackgroundIn aging populations, the number of people with high cholesterol levels is increasing. Appropriate management of high cholesterol levels with drugs such as statins may prevent secondary diseases. Despite many studies on the effects of statins on various types of cancer, the effectiveness of lipid-lowering therapy in preventing cancer remains controversial. This study aimed to evaluate its long-term effect on developing gastrointestinal (GI) cancer in patients with dyslipidemia.MethodsThis study used the National Health Insurance Sampling (NHIS) cohort data (2002–2015), which included patients with dyslipidemia without diabetes, and measured patients’ adherence to lipid-lowering therapy using the medication possession ratio. We used the Cox proportional hazard ratio (HR) to identify the association between the continuity of lipid-lowering therapy and the risk of GI cancer. We also evaluated the association between a combination of lipid-lowering drugs and a reduced risk of GI cancer.ResultsA total of 49,351 patients were diagnosed with dyslipidemia, of which 579 were diagnosed with GI cancer. Patients with higher adherence to lipid-lowering therapy had a significantly reduced risk of GI cancer compared to patients without drugs, and high adherence was associated with a reduced incidence of all types of GI cancer. Specifically, the combination of statins and ezetimibe or fibrates appears to reduce GI cancer risk effectively. Overall, the continuity of lipid-lowering therapy had a protective effect on GI cancer in middle-aged and elderly patients with dyslipidemia compared to non-users.ConclusionsOur findings suggest that the continuity of lipid-lowering therapy is vital in patients with dyslipidemia. In addition, for individuals vulnerable to GI cancer, combination therapy may be associated with more effective protection against GI cancer. Healthcare providers need patient education and monitoring to improve drug adherence in patients with dyslipidemia.
Highlights
In aging populations, the number of people with high cholesterol levels is increasing
Dyslipidemia is a risk factor for various diseases, including cardiovascular disease (CVD), and high serum cholesterol is frequently associated with an increased risk of esophageal and colorectal cancer (CRC) [5, 6] and cancer progression [7, 8]
A total of 49,351 patients were diagnosed with dyslipidemia, of which 579 (1.2%) were diagnosed with GI cancer
Summary
The number of people with high cholesterol levels is increasing. Appropriate management of high cholesterol levels with drugs such as statins may prevent secondary diseases. This study aimed to evaluate its long-term effect on developing gastrointestinal (GI) cancer in patients with dyslipidemia. CVD and cancer, which are closely associated with lifestyle behaviors, share common risk factors [4], including dyslipidemia; the effective management of these risk factors may impact both CVD and cancer. Dyslipidemia is a risk factor for various diseases, including CVD, and high serum cholesterol is frequently associated with an increased risk of esophageal and colorectal cancer (CRC) [5, 6] and cancer progression [7, 8]. Abnormal cholesterol levels may influence cancer incidence considering these studies, and cholesterol treatment may affect cancer development
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