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.

Clinical Trial Unit Masaryk Memorial Cancer Institute 656 53 Brno Czech Republic

Department of Comprehensive Cancer Care Faculty of Medicine Masaryk University 625 00 Brno Czech Republic

Department of Comprehensive Cancer Care Masaryk Memorial Cancer Institute 656 53 Brno Czech Republic

Department of Medical Ethics Faculty of Medicine Masaryk University 625 00 Brno Czech Republic

Department of Pharmacology Faculty of Medicine Masaryk University 625 00 Brno Czech Republic

Department of Pharmacy Masaryk Memorial Cancer Institute 656 53 Brno Czech Republic

Department of Pharmacy University Hospital Brno 625 00 Brno Czech Republic

Department of Radiation Oncology Faculty of Medicine Masaryk University 625 00 Brno Czech Republic

Department of Radiation Oncology Masaryk Memorial Cancer Institute 656 53 Brno Czech Republic

Department of Surgical Oncology Faculty of Medicine Masaryk University 625 00 Brno Czech Republic

Department of Surgical Oncology Masaryk Memorial Cancer Institute 656 53 Brno Czech Republic

Institute of Biostatistics and Analyses Faculty of Medicine Masaryk University 625 00 Brno Czech Republic

Institute of Health Information and Statistics of the Czech Republic 128 01 Prague Czech Republic

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