Statin Use Associated With Decreased Risk of Barrett's Esophagus

Key Points

  • Barrett’s esophagus increases the risk of esophageal cancer by 10- to 55-fold.
  • Patients who received statins had a 43% reduction in risk of developing Barrett’s esophagus compared to nonusers.
  • The protective effect of statins was especially significant in obese patients, those with frequent gastroesophageal reflux disease symptoms, and those who used statins for 3 or more years.

Statin use was associated with a significantly reduced risk of developing Barrett’s esophagus, according to a new study by Nguyen et al in Gastroenterology. Obese patients experienced the greatest level of risk reduction with statin use. While statins have been associated with a reduced risk of esophageal cancer, this is one of the first studies to look at their effect on development of Barrett's esophagus.

“Patients who received statins had a 43% reduction in the odds of having Barrett’s esophagus compared to nonusers,” said study author Hashem B. El-Serag, MD, MPH, from the Houston VA Medical Center and Baylor College of Medicine, Houston. “This is the first study to find a significantly lower risk of Barrett’s esophagus with statin use, independent of other known risk factors. Further studies are needed to examine this association.”

Barrett’s esophagus affects 1% to 2% of the general population and is the only known precancerous lesion for esophageal cancer. Barrett’s esophagus increases the risk of developing this cancer by 10- to 55-fold compared with the general population.

Study Details

Researchers conducted a large, single-center, case-control study of 303 patients with Barrett’s esophagus and 909 controls treated at the Michael E. DeBakey Veteran Affairs Medical Center in Houston. They compared electronic pharmacy records during a 10-year period to ascertain medication use and evaluated the association between the use of statins and the risk of Barrett’s esophagus. The findings indicate that statins may have a protective effect against the development of Barrett’s esophagus. This association was independent of known risk factors, including age, race, gender, Helicobacter pylori infection, and smoking status.

The protective effect of statins was especially significant among patients who were obese. Those with a body mass index greater than or equal to 30 had a 74% reduction in Barrett’s esophagus.

Patients who had frequent gastroesophageal reflux disease symptoms had a 59% reduction in Barrett’s esophagus odds. The researchers also found that patients who used statins for 3 or more years had higher risk reduction.

The authors noted that this study was conducted at a single-center VA medical center, where the patient population consisted mostly of older men, and so results may not be generalizable to a wider population. In addition, since simvastatin was by far the most commonly prescribed statin in this study (94.3%), generalizability to other statins may be limited.

Dr. El-Serag is the corresponding author for the Gastroenterology article.

The study was funded by grants from the National Institutes of Health and the Texas Digestive Disease Center. The study authors reported no potential conflicts of interest.

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