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

Abstract: The potential protective effect of renin?angiotensin system (RAS) inhibitors is a subject of increasing interest due to their possible role as chemopreventive agents against colorectal cancer (CRC). To evaluate this association, we conducted a case-control study with 2165 cases of colorectal cancer, diagnosed between 2007 and 2012, and 3912 population controls frequency matched (by age, sex and region) fromthe Spanishmulticenter case-control studyMCCSpain. We found a significant protective effect of the angiotensin-converting enzyme Inhibitors (ACEIs) against CRC, limited to the under-65 years group (OR=0.65 95%CI (0.48?0.89)) and to a lesser degree tomen (OR=0.81 95%CI (0.66?0.99). In contrast, the angiotensin receptor blockers (ARBs) did not show a significant effect. Regarding the duration of use, a greater protection was observed in men as the length of consumption increases. In contrast, in the under-65 stratum, the strongest association was found in short-term treatments. Finally, by analyzing ACEIs effect by colon subsite, we found no differences, except for under 65 years old, where the maximum protection was seen in the proximal intestine, descending in the distal and rectum (without statistical significance). In conclusion, our study shows a protective effect on CRC of the ACEis limited to males and people under 65 years old, which increases in proximal colon in the latter. If confirmed, these resultsmay suggest a novel approach to proximal CRC prevention, given the shortcomings of colonoscopy screening in this location.

 Autoría: Dierssen-Sotos T., Gómez-Acebo I., Palazuelos C., Rodriguez-Moranta F., Pérez-Gómez B., Fernández Vazquez J.P., Amiano P., Barricarte A., Mirón-Pozo B., Tardon A., Capelo R., Peiro Pérez R., Huerta J.M., Andreu M., Sierra M.Á., Castañón López C., Ruiz I., Moreno-Iribas C., Olmedo-Requena R., Castaño-Vinyals G., Aragonés N., Kogevinas M., Pollán M., Llorca J.,

 Fuente: Preventive Medicine, 2017, 99, 178-184

 Editorial: Elsevier

 Fecha de publicación: 01/06/2017

 Nº de páginas: 7

 Tipo de publicación: Artículo de Revista

 DOI: 10.1016/j.ypmed.2017.01.011

 ISSN: 0091-7435,1096-0260

 Url de la publicación: https://doi.org/10.1016/j.ypmed.2017.01.011

Autoría

RODRIGUEZ MORANTA, FRANCISCO

PÉREZ GÓMEZ, BEATRIZ

FERNÁNDEZ VAZQUEZ, JOSÉ PEDRO

AMIANO, PILAR

BARRICARTE, AURELIO

MIRÓN POZO, BENITO

TARDON, ADONINA

CAPELO, ROCÍO

PEIRO PÉREZ, ROSANA

HUERTA, JOSÉ MARÍA

ANDREU, MONTSERRAT

SIERRA, Mª ÁNGELES

CASTAÑÓN LÓPEZ, CARMEN

RUIZ, IRUNE

MORENO IRIBAS, CONCEPCIÓN

OLMEDO REQUENA, ROCÍO

FRANCISCO JAVIER LLORCA DIAZ