Statin exposure and risk of colorectal cancer in patients with inflammatory bowel disease: a systematic review and meta-analysis

Background: While epidemiological studies have linked statin use to a reduced risk of advanced colorectal adenomas, its impact on colorectal cancer (CRC) risk in patients with inflammatory bowel disease (IBD) remains unclear. To our knowledge, no meta-analysis to date has specifically examined this association. Therefore, we conducted a systematic review and meta-analysis of the available observational studies to investigate the risk of CRC associated with statin use in IBD patients. Methods: We searched three databases for articles published in English before September 2024, focusing on the protective effects of statins against CRC in IBD patients. We calculated multivariate odds ratios (ORs) and their 95% confidence intervals (CIs) to assess this association. A random-effects meta-analysis was conducted using the generic inverse variance method. Results: The meta-analysis included 4 studies encompassing 22,250 IBD patients, 6,712 of whom were statin users. The methodological quality of three of the studies was deemed high. We found a significantly lower risk of CRC in statin users compared to non-users, with a pooled relative risk of 1.88 (95% CI 1.54-2.30). Sensitivity analyses confirmed the consistency of these findings. Conclusion: Statin use appears to be associated with a reduced risk of CRC in patients with IBD. However, given the limited number of studies available, further prospective research with large sample size is necessary to confirm the potential chemopreventive role of statins in this population.