Statin Use is Associated With Reduced Risk of Histologic Subtypes of Esophageal Cancer: a Nested Case–Control Analysis
Menée à partir des données 2000-2009 de registres médicaux du Royaume-Uni portant sur 1 126 patients atteints d'un cancer de l'œsophage et 2 169 025 témoins, cette étude met en évidence une association entre l'utilisation régulière de statines et une réduction du risque de certains sous-types de la maladie
Background & Aims : Most patients with esophageal adenocarcinoma (EAC) or squamous cell cancer (ESCC) present with advanced, incurable disease. Statins have reported anti-carcinogenic effects and may be chemoprotective. We investigated the association between regular use of statins and the main histologic subtypes of esophageal malignancy (EAC, esophagogastric junctional adenocarcinoma [EGJA], and ESCC) in the UK general population. Methods : We identified all individuals in the UK General Practice Research Database diagnosed with esophageal cancer from 2000 through 2009. Cases were linked to the National Cancer Registry to confirm histologic subtypes. Each case was matched with up to 4 controls for age, sex, and practice. We performed a nested case–control analysis, using conditional logistic regression, to estimate the risk of each subtype with regular statin use, adjusted for body mass index, smoking, alcohol intake, and concomitant use of medications. Results : In total, 581 participants with EAC, 213 with EGJA, and 332 with ESCC were matched to 2167, 783, and 1242 controls, respectively. Regular statin use was inversely associated with the development of EAC (odds ratio [OR], 0.58; 95% confidence interval [CI], 0.39–0.87) (with significant dose and duration responses) and EGJA (OR, 0.29; 95% CI, 0.09–0.92) (with high-dose use only). Statin use for 1–4 years was inversely associated with ESCC (OR, 0.51; 95% CI, 0.27–0.98). Conclusions : In a nested case–control analysis of a UK population-based cohort, statin use was inversely associated with histologic subtypes of esophageal cancer. Randomized controlled trials are warranted to determine whether statins have chemopreventive effects in high-risk groups.
http://linkinghub.elsevier.com/retrieve/pii/S0016508513017277?showall=true