ACG: Statins Protect Against Esophageal Cancer

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(ChemotherapyAdvisor) – Use of statins have a chemopreventive effect in patients with esophageal cancer, particularly in those with Barrett's esophagus, a meta-analysis of observational studies presented at the American College of Gastroenterology's 77th Annual Scientific Meeting in Las Vegas, NV, has found.

Siddharth Singh, MBBS, of the Mayo Clinic, Rochester, MN, and colleagues conducted a systematic review of clinical studies that evaluated the effect of statin use on risk of esophageal cancer, including a focus on disease development or dysplasia progression in patients with Barrett's esophagus. A total of 11 studies reporting 8,613 cases of esophageal cancer in 995,687 patients were identified.

A 30% reduction in incidence of esophageal cancer was found with statin use (adjusted OR 0.70; 95% CI 0.57–0.86) “though there was considerable heterogeneity, attributable partly to method of ascertainment of exposure to statins,” Dr. Singh noted.

When their analysis was restricted to seven “high-quality observational studies…use of statins continued to show a significant protective effect against development of esophageal cancer (adjusted OR 0.70, 95% CI 0.56–0.88),” they reported.

Analysis of a subset of patients with known Barrett's esophagus found use of statins significantly decreased risk of esophageal adenocarcinoma, after adjusting for potential confounders (adjusted OR 0.59; 95% CI 0.45–0.78). Results were consistent across the 5 studies, in which 312 of 2,125 patients had esophageal adenocarcinoma.

To prevent 1 case of esophageal adenocarcinoma in patients with Barrett's esophagus, 389 patients need to be treated with statins, they found.

A greater protective effect was observed both with longer duration of statin use (adjusted OR 0.44; 95% CI 0.24-0.78), and combined use of statins and nonsteroidal antiinflammatory medications, including aspirin (adjusted OR 0.28; 95% CI 0.14–0.56).

“Given the high mortality rates after a diagnosis of esophageal adenocarcinoma, these results support chemoprevention trials evaluating statins in populations at high risk of developing esophageal adenocarcinoma,” Dr. Singh concluded.

Link to abstract (select Oral & Posters, Browse by Number and select Abstract Number 1):

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