title: Regular statin and aspirin use in patients with Barrett's oesophagus is associated with a reduced incidence of oesophageal adenocarcinoma.
abstract: BACKGROUND
  Oesophageal adenocarcinoma (OAC) has a poor prognosis, and chemoprevention is an attractive option to reduce the burden of the disease. Hydroxyl-methyl-CoA reductase inhibitors (statins) have been shown to exert potentially useful anticancer effects against OAC cell lines, but there are only limited clinical data examining the effects of statins on the incidence of OAC.
  
  
  OBJECTIVE
  To examine the association between statin use and the incidence of OAC.
  
  
  METHODS
  We have carried out a case-control study comparing statin use between patients with an incident diagnosis of OAC and controls with nonprogressive Barrett's oesophagus. Eighty-five cancer cases were compared with 170 age-matched and sex-matched controls. Risk factors and drug exposure were established using standardized interviews. Logistic regression was used to compare statin exposure and correct for confounding factors.
  
  
  RESULTS
  Regular statin use was associated with a significantly lower incidence of OAC [uncorrected odds ratio (OR) 0.45, 95% confidence intervals 0.24-0.84)]. After correction for confounding variables including aspirin and NSAID use, statin use was still associated with a reduced incidence of OAC (OR 0.57, 0.28-0.94). Longer duration of statin use and higher doses were both associated with a significantly greater reduction in OAC. The combination of regular statin and aspirin use was associated with a significantly further reduced incidence of OAC (OR 0.31, 0.04-0.69).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Gastroenterology, Norfolk and Norwich University Hospital bNorwich Medical School, University of East Anglia, Norwich, UK. i.beales@uea.ac.uk
authors.forename: Ian L P
authors.initials: IL
authors.lastname: Beales
authors.forename: Inna
authors.initials: I
authors.lastname: Vardi
authors.forename: Leanne
authors.initials: L
authors.lastname: Dearman
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D001241:Aspirin / Q000008:administration & dosage*; D001471:Barrett Esophagus / Q000188:drug therapy; D016022:Case-Control Studies; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D004938:Esophageal Neoplasms / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D015994:Incidence; D008297:Male; D008875:Middle Aged
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D001241:Aspirin