Regular statin and aspirin use in patients with Barrett’s oesophagus is associated with a reduced incidence of oesophageal adenocarcinoma

Abstract

In this observational case-control study, the regular use of statins was associated with a reduced incidence of OAC. The chemopreventative actions of statins, especially in conjunction with aspirin, deserve further study.

Reduced Risk of Barrett’s Esophagus in Statin Users: Case–Control Study and Meta-Analysis

“…The differences between the groups were quantified using the calculated odds ratios and 95% confidence intervals, with the significance level set at P < 0.05. Unconditional logistic regression was used to correct for potentially confounding 8 factors: age, smoking, alcohol use, body mass index, waist circumference and all prescribed and over the counter mediations recorded (14,15,19).…”

“…The main strengths of our study are the accurate and full records of medication exposure as reported previously (14,15,23) and the ability to correlate this with clearly defined endoscopic findings within the context of an adequately powered study. The main weakness, inherent in any observational study, is that of uncorrected bias.…”

“…Controls and cases were recruited as part of a larger project examining risk and prognostic factors for gastrointestinal diseases (14,15,19). All subjects were planned to undergo their first ever gastroscopy.…”

“…All subjects were planned to undergo their first ever gastroscopy. All subjects were interviewed by trained interviewers immediately preceding their endoscopy as previously reported (14,15,19). The standardised interview included demographic and social details, prescribed and over-the-counter medicine use.…”

“…Statins inhibit proliferation, induce apoptosis and inhibit growth factor signalling in Barrett's cell lines (10,11) and whilst COX-pathway inhibitors also have experimental anticancer effects, these are additive to those of statins (10)(11)(12). Several observational studies and two metaanalyses (13)(14)(15)(16)(17) have reported that statin use is associated with a lower rate of progression to cancer in patients with Barrett's oeosphagus and again this effect is significantly enhanced in combination with aspirin (16). In a meta-analysis, pooled adjusted odds ratios showed that statin use in the Barrett's population was associated with a 43% reduction in the risk of malignant progression (OR = 0.57 (95% CI 0.43-0.75)) and this effect was even more pronounced in those concurrently using low-dose aspirin (OR 0.26 (95% CI 0.1-0.68)) (16).…”