Lipid metabolism in colorectal cancer: dual roles and statin therapy

Colorectal cancer (CRC) remains a prevalent global malignancy with increasing incidence. This review systematically explores the intricate and often paradoxical dual roles of lipid metabolism components-triglycerides, cholesterol, HDL-C, and LDL-C-in CRC development and progression. A key focus is on the therapeutic potential of statins, cornerstone lipid-lowering agents. We summarize evidence that statins may confer protection through multifaceted mechanisms: inhibiting HMG-CoA reductase, modulating inflammation and immune responses, and reprogramming the gut microbiome. However, we critically synthesize the significant controversy surrounding their efficacy, attributing discrepant findings to factors such as statin lipophilicity, treatment duration, and tumor anatomical subsite. Ultimately, this review highlights the complex interplay between lipids and CRC and underscores the need for stratified, personalized approaches in future research and potential therapeutic applications.