Association between statin use after diagnosis of esophageal cancer and survival: a population-based cohort study

Alexandre, Leo, Clark, Allan B. ORCID: https://orcid.org/0000-0003-2965-8941, Bhutta, Hina Y., Chan, Simon S. M., Lewis, Michael P. N. and Hart, Andrew R. (2016) Association between statin use after diagnosis of esophageal cancer and survival: a population-based cohort study. Gastroenterology, 150 (4). pp. 854-865. ISSN 0016-5085

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Abstract

Background & Aims: Statins (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors), commonly prescribed to prevent cardiovascular disease, promote apoptosis and limit proliferation of esophageal cancer cell lines. We investigated whether statin use following diagnosis of esophageal cancer is associated with reduced esophageal cancer-specific and all-cause mortality.  Methods: We identified a cohort of 4445 men and women in the United Kingdom diagnosed with esophageal cancer from January 2000 through November 2009 using the General Practice Research Database. The National Cancer Registry and Office of National Statistics datasets respectively established the histologic subtype and cancer-specific mortality. Cox proportional hazard regression analysis with time-dependent exposures estimated the association between statin use after diagnosis and esophageal cancer-specific and all-cause mortality.  Results: The median survival time of the entire cohort was 9.2 months (inter-quartile range [IQR], 3.7–23.2 months). Among subjects who used statins after diagnosis of esophageal cancer, the median survival time was 14.9 months (IQR, 7.1–52.3) compared to 8.1 months for non-users (IQR, 3.3–20). In the entire cohort, statin use after diagnosis was associated with a decreased risk of esophageal cancer-specific mortality (adjusted hazard ratio [HR], 0.62; 95% confidence interval [CI], 0.44–0.86) and all-cause mortality (HR, 0.67; 95% CI, 0.58–0.77). In patients with esophageal adenocarcinoma, statin use after diagnosis was associated with decreased risk of esophageal cancer-specific mortality (HR, 0.61; 95% CI 0.38–0.96) and all-cause mortality (HR, 0.63; 95% 0.43–0.92). This effect was not observed in patients with esophageal squamous cell carcinoma. There was no evidence for effect modification of these associations with statin use before cancer diagnosis.  Conclusions: In a large population-based cohort, statin use after diagnosis of esophageal adenocarcinoma, but not esophageal squamous cell carcinoma, was associated with reduced esophageal cancer-specific and all-cause mortality.

Item Type: Article
Uncontrolled Keywords: hmg-coa,pleiotropy,esophagus,cprd,sdg 3 - good health and well-being ,/dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_being
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Groups > Epidemiology and Public Health
Faculty of Medicine and Health Sciences > Research Groups > Public Health and Health Services Research (former - to 2023)
Faculty of Medicine and Health Sciences > Research Groups > Norwich Clinical Trials Unit
Faculty of Medicine and Health Sciences > Research Groups > Health Services and Primary Care
Faculty of Medicine and Health Sciences > Research Groups > Gastroenterology and Gut Biology
Faculty of Science > Research Groups > Norwich Epidemiology Centre
Faculty of Medicine and Health Sciences > Research Groups > Norwich Epidemiology Centre
Faculty of Medicine and Health Sciences > Research Centres > Population Health
Depositing User: Pure Connector
Date Deposited: 22 Mar 2016 09:21
Last Modified: 19 Oct 2023 01:36
URI: https://ueaeprints.uea.ac.uk/id/eprint/57724
DOI: 10.1053/j.gastro.2015.12.039

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