title: Use of statin medications and risk of esophageal adenocarcinoma in persons with Barrett's esophagus.
abstract: BACKGROUND
  Persons with Barrett's esophagus experience increased incidence of esophageal adenocarcinoma and may benefit from use of preventives. Studies suggest that statin medications may have chemopreventive properties; we therefore assessed the association between statin use and progression to esophageal adenocarcinoma.
  
  
  METHODS
  In a prospective cohort of 411 persons with Barrett's, Cox regression was used to calculate HRs for nonsteroidal anti-inflammatory drug (NSAID) and statin use accounting for variation in use during follow-up and adjusting for age, sex, and smoking.
  
  
  RESULTS
  The HRs for statin use among all participants were 0.59 [95% confidence interval (CI), 0.26-1.33] and 0.68 (95% CI, 0.30-1.54) before and after further adjustment for NSAID use, respectively. Among persons with high-grade dysplasia, the HRs for statin use were 0.31 (95% CI, 0.11-0.86) and 0.41 (95% CI, 0.13-1.26) before and after adding NSAIDs to the model, respectively.
  
  
  CONCLUSIONS
  While the reduced risk of esophageal adenocarcinoma observed among statin users may be explained by chance, the point estimates are similar in magnitude to those previously reported for NSAID use in this cohort and are unlikely to be confounded by known risk factors.
  
  
  CONCLUSIONS
  Further study in larger cohorts and meta-analyses of the potential for statins to reduce risk of esophageal adenocarcinoma is warranted.
authors.affiliation: Public Health Sciences, FredHutchinson Cancer Research Center; and Departments of Epidemiology, University of Washington, Seattle, Washington 98109, USA. tvaughan@fhcrc.org
authors.forename: Elizabeth D
authors.initials: ED
authors.lastname: Kantor
authors.forename: Lynn
authors.initials: L
authors.lastname: Onstad
authors.forename: Patricia L
authors.initials: PL
authors.lastname: Blount
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Reid
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Vaughan
mesh_terms: D000230:Adenocarcinoma / Q000139:chemically induced*; D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D001471:Barrett Esophagus / Q000188:drug therapy*; D018450:Disease Progression; D004938:Esophageal Neoplasms / Q000139:chemically induced*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors