Letter: statin use and the risk of oesophageal cancer

Authors

  • S.-W. Lai,

    1. School of Medicine, China Medical University, Taichung, Taiwan
    2. Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
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    • These authors contributed equally to this study.
  • C.-Y. Lin,

    1. Department of Internal Medicine, Taichung Tzu Chi General Hospital, Taichung, Taiwan
    2. School of Medicine, Tzu Chi University, Hualien, Taiwan
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    • These authors contributed equally to this study.
  • K.-F. Liao

    1. Department of Internal Medicine, Taichung Tzu Chi General Hospital, Taichung, Taiwan
    2. School of Medicine, Tzu Chi University, Hualien, Taiwan
    3. Department of Health Care Administration, Central Taiwan University of Science and Technology, Taichung, Taiwan
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    • These authors contributed equally to this study.

Sirs,

Whether the use of statins is associated with oesophageal cancer risk remains unproven. One systematic review recently published has shown that prior statin use could correlate with a 14–47% risk reduction of oesophageal cancer.[1] However, the authors did not find any link between histological subtypes of oesophageal cancer and statin use in general population cohorts.

In our case–control study utilizing the Taiwan National Health Insurance database, we found that statin use could correlate with a 34% risk reduction of oesophageal cancer (95% CI: 0.45–0.95).[2] Similarly, we could not examine data for squamous cell carcinoma and adenocarcinoma separately, due to the inherent limitations of this database, although more than 95% of oesophageal cancer cases were diagnosed as squamous cell carcinoma in Taiwan,[3] which is obviously different from in Western populations.

In sub-analysis, we also found that atorvastatin (one lipophilic statin) with cumulative exposure duration ≥12 months might correlate with decreased risk of oesophageal cancer (odds ratio 0.14, 95% CI: 0.04–0.56). This indicates a further study direction about the structural differences of statins on the effect of oesophageal cancer risk.

Because the role of statin use in preventing oesophageal cancer is not well established, its routine use for primary prevention cannot be recommended at present. Thus, more prospective clinical trials are required to definitively clarify this issue.

Acknowledgement

Declaration of personal and funding interests: None.

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