Statins are associated with reduced risk of esophageal cancer, particularly in patients with Barrett's esophagus: a systematic review and meta-analysis.
OBJECTIVE
The incidence of esophageal cancer is increasing in the United States, especially among patients with Barrett's esophagus (BE). Statins might prevent this cancer. We performed a systematic review with a meta-analysis of studies that evaluated the effect of statins on the risk of esophageal cancer.


METHODS
We conducted a systematic search of Medline, Embase, and Web of Science through August 2012. Studies were included if they evaluated exposure to statins, reported the development of esophageal cancer, and reported relative risks or odds ratios (OR), or provided data for their estimation. Summary OR estimates with 95% confidence intervals (CI) were calculated using the random-effects model. The analysis included 13 studies (including a post hoc analysis of 22 randomized controlled trials) reporting 9285 cases of esophageal cancer among 1,132,969 patients.


RESULTS
A meta-analysis of the studies showed a significant (28%) reduction in the risk of esophageal cancer among patients who took statins (adjusted OR, 0.72; 95% CI, 0.60-0.86), although there was considerable heterogeneity among studies. In analyzing a subset of patients known to have BE (5 studies, 312 esophageal adenocarcinomas [EAC] developed in 2125 patients), statins were associated with a significant (41%) decrease in the risk of EAC, after adjusting for potential confounders (adjusted OR, 0.59; 95% CI, 0.45-0.78) with consistent results among all studies. The number needed to treat with statins to prevent 1 case of EAC in patients with BE was 389.


CONCLUSIONS
Based on meta-analysis of observational studies, statin use may be associated with lower risk of esophageal cancer, particularly risk of EAC in patients with BE.
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.
Siddharth
S
Singh
Abha Goyal
AG
Singh
Preet Paul
PP
Singh
Mohammad Hassan
MH
Murad
Prasad G
PG
Iyer
D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D001471:Barrett Esophagus / Q000150:complications*; D004938:Esophageal Neoplasms / Q000453:epidemiology* / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D018570:Risk Assessment
D000924:Anticholesteremic Agents