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Relationship between drugs affecting the renin-angiotensin system and colorectal cancer: The MCC-Spain study

Trinidad Dierssen-Sotos1, Inés Gómez-Acebo1, Camilo Palazuelos2

  • 1Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública- CIBERESP), Madrid, Spain; Division of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, IDIVAL, Santander, Spain.

Preventive Medicine
|January 30, 2017
PubMed

Insights

Angiotensin-converting enzyme inhibitors (ACEIs) show a protective effect against colorectal cancer (CRC), particularly in men and individuals under 65. This finding may offer new strategies for proximal CRC prevention.

Area of Science:

  • Oncology
  • Pharmacology
  • Epidemiology

Background:

  • The renin-angiotensin system (RAS) inhibitors are being investigated for their potential chemopreventive role in colorectal cancer (CRC).
  • Understanding the specific effects of different RAS inhibitors, such as ACEIs and ARBs, is crucial for cancer prevention strategies.

Purpose of the Study:

  • To evaluate the association between the use of RAS inhibitors and the risk of developing colorectal cancer.
  • To investigate the differential effects of ACEIs and ARBs on CRC risk based on patient demographics and treatment duration.

Main Methods:

  • A multicenter case-control study (MCC-Spain) involving 2165 CRC cases and 3912 controls, frequency-matched by age, sex, and region.
  • Analysis of ACEIs and ARBs use, stratified by age, sex, and duration of treatment, to assess their association with CRC risk.

Main Results:

  • ACEIs demonstrated a significant protective effect against CRC, notably in individuals under 65 years old (OR=0.65) and to a lesser extent in men (OR=0.81).
  • ARBs did not show a significant association with CRC risk.
  • For ACEIs, protection increased with longer use in men, while short-term use showed the strongest association in the under-65 group. A trend towards greater protection in the proximal colon was observed in younger individuals.

Conclusions:

  • ACEIs exhibit a protective effect against CRC, specifically in males and individuals under 65 years old.
  • The findings suggest a potential novel approach for proximal CRC prevention, especially considering limitations in current screening methods like colonoscopy.
Keywords:
Angiotensin converting enzyme inhibitorAngiotensin receptor blockerColorectal cancer

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