ACG: Statins Protect Against Esophageal Cancer
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):