Introduction Oesophageal carcinoma (OC) is the sixth leading cause of cancer-related mortality in the world. Experimental 1 and clinical 2 evidence have shown that statins could potentially play a role in reducing OC incidence. This effect has been studied in new observational data.This is a meta-analysis examining available evidence to assess the impact of statin use on the incidence of OC.
Method A systematic literature search of Medline, Embase was used to identify studies that were pertinent to the research objective. Included studies were assigned into one of three subgroup analyses examining incidence of: adenocarcinoma (OAC) in Barrett’s oesophagus (BO) cohort, OAC in population cohorts and all types of OC in population cohorts.
Forty-seven studies were identified through the literature search. Review Manager (Revman) version 5.3 was used to calculate the pooled risk ratio, compiling odds ratios (OR) or hazard ratios (HR) from individual studies using the inverse variance method, random effects model. Due to the relative rarity of outcomes, OR were considered as approximations of HR and relative risk (RR).
Results Eighteen studies qualified for inclusion in statistical analysis. Adjusted data showed that statin use exhibited a protective effect on the incidence of OAC in the BO cohort (OR 0.59; 95% CI 0.50 to 0.68) – 41% decrease. This effect was apparent even in unadjusted data which showed OR 0.54; 95% CI (0.46 to 0.63). No significant heterogeneity was observed.
Statins were also shown to have a protective effect on the incidence of OAC in the population cohort (OR 0.57; 95% CI 0.43 to 0.76) – 43% decrease and incidence of all types of OC in the population cohort (OR 0.82; 95% CI 0.76 to 0.88) – 18% decrease. No significant heterogeneity was observed in the adjusted datasets. Due to the heterogeneity in data reporting, statistical analysis was deemed unreliable for examining any relationship between statin characteristics and OC incidence.
Conclusion Statin use could potentially be protective against oesophageal carcinoma, particularly against OAC in a risk-stratified BO cohort. This meta-analysis is an update on the literature aiming to clarify the potential clinical impact of statin use through analysis of approximately 3 73 263 cases of OC and 6,104,647 cases of BO and other non-cancer patients. Further research is merited to examine its potential role in chemopreventative strategies.
. Ogunwubi OO. Beales IL. “Statins inhibit proliferation and induce apoptosis in Barrett’s esophageal adenocarcinoma cells”American Journal of Gastroenterology (2008);103:825–837
. Beales IL, et al. “Reduced esophageal cancer incidence in statin users, particularly with cyclo-oxygenase inhibition” World Journal of Gastrointestinal Pharmacology and Therapeutics (2013);4(3):69–79
Disclosure of Interest None Declared
- Barrett’s Oesophagus
- oesophageal cancer