Systematic Review and Meta-analysis: Use of Statins Is Associated with a Reduced Incidence of Oesophageal Adenocarcinoma

Abstract

PurposeLaboratory studies have suggested that statins may have useful anti-cancer effects against Barrett’s epithelial cancer lines. A variety of effects have been reported in clinical studies.MethodsWe performed a systematic review and meta-analysis of the association between statin use and the development of oesophageal cancer. Multiple databases were searched for studies reporting the association of statin use and oesophageal cancer. Meta-analysis on the relationship between statin use and cancer incidence was performed.ResultsTwenty publications met eligibility criteria, yielding 22 datasets for meta-analysis. All were observational studies. Population-level studies included 372,206 cancer cases and 6,086,906 controls. Studies examining adenocarcinoma development in Barrett’s oesophagus included 1057 cancers and 17,741 controls. In patients with Barrett’s oesophagus, statin use was associated with a reduced incidence of adenocarcinoma (pooled adjusted odds ratio (OR) 0.59 (95% confidence intervals 0.50–0.68)), with no heterogeneity between 11 studies. Population-based studies demonstrated more heterogeneity but showed that statin use was associated with a lower incidence of both oesophageal adenocarcinoma (OR 0.57 (0.43–0.76)) and all oesophageal cancers (OR 0.82 (0.7–0.88)). Information on statin type, dose, and duration was reported too infrequently for statistical analysis but individual studies showed a tendency to a dose- and duration-dependant decrease in cancer incidence.ConclusionsStatin use is associated with a significantly lower incidence of oesophageal adenocarcinoma. This is seen in both Barrett’s cohorts and general populations. Further studies should focus on drug, dose, and duration and the interaction with other risk and preventative factors.Electronic supplementary materialThe online version of this article (doi:10.1007/s12029-017-9983-0) contains supplementary material, which is available to authorized users.

Tree nut, peanut, and peanut butter consumption and the risk of gastric and esophageal cancer subtypes: the Netherlands Cohort Study

“…However, no evidence regarding this association is available. In addition, in recent years, several publications have hypothesized that statin use reduces esophageal and gastric cancer risk [39][40][41]. We recommend future studies to take these factors into account as well.…”

Epidemiology of Barrett’s oesophagus and oesophageal adenocarcinoma

“…However, a recent study by Thrift et al showed that regular (at least once weekly) use of any NSAIDs was not associated with the risk of BO [86]. Studies have shown that regular statin use was inversely associated with the development of OAC and BO [87][88][89][90]. Studies have also shown that use of lower oesophageal sphincter relaxing drugs like nitroglycerin, anticholinergics, and b-adrenergic agonists was positively associated with risk for OAC [91,92].…”

Chemoprevention of esophageal adenocarcinoma

“…A 2017 meta-analysis of 11 studies, comprising almost 19,000 patients with BE, showed an OR of 0.59 of EAC among statin users, with consistent effects seen across all included studies (95% CI 0.50–0.68) [ 56 ]. This benefit might be dose-related, as Beales et al [ 57 ] demonstrated a reduced OR of EAC in patients taking high-dose statin therapy (equivalent to simvastatin 40 mg daily or higher) compared with that in those taking low-dose therapy (OR 0.31, 95% CI 0.05–0.97 vs OR 0.54, 95% CI 0.27–0.98).…”