15 research outputs found
Reduced risk of Barrettās esophagus in statin users: caseācontrol study and meta-analysis
Background: Use of statins has been associated with a reduced incidence of esophageal adenocarcinoma in population-based studies. However there are few studies examining statin use and the development of Barrettās esophagus. Aim: The purpose of this study was to examine the association between statin use and the presence of Barrettās esophagus in patients having their first gastroscopy. Methods: We have performed a caseācontrol study comparing statin use between patients with, and without, an incident diagnosis of non-dysplastic Barrettās esophagus. Male Barrettās cases (134) were compared to 268 male age-matched controls in each of two control groups (erosive gastro-esophageal reflux and dyspepsia without significant upper gastrointestinal disease). Risk factor and drug exposure were established using standardised interviews. Logistic regression was used to compare statin exposure and correct for confounding factors. We performed a meta-analysis pooling our results with three other caseācontrol studies. Results: Regular statin use was associated with a significantly lower incidence of Barrettās esophagus compared to the combined control groups [adjusted OR 0.62 (95 % confidence intervals 0.37ā0.93)]. This effect was more marked in combined statin plus aspirin users [adjusted OR 0.43 (95 % CI 0.21ā0.89)]. The inverse association between statin or statin plus aspirin use and risk of Barrettās was significantly greater with longer duration of use. Meta-analysis of pooled data (1098 Barrettās, 2085 controls) showed that statin use was significantly associated with a reduced risk of Barrettās esophagus [pooled adjusted OR 0.63 (95 % CI 0.51ā0.77)]. Conclusions: Statin use is associated with a reduced incidence of a new diagnosis of Barrettās esophagus
Risk factors for Barrett's esophagus : a scoping review
IntroductionCancer of the esophagus is a highly lethal
disease with many patients presenting with metastatic
spread of their tumor at diagnosis; a consequence of this
late presentation is the 5-year survival rate of \20 %.
Barrettās esophagus (BE), a premalignant condition of the
distal esophagus, is the main risk factor for adenocarcinoma
of the esophagus. The development of a risk prediction
tool that could assist healthcare professionals in
identifying people at increased risk of developing BE
would be advantageous. Understanding the factors that
influence the risk of developing BE is the first stage of
developing a risk prediction tool.
MethodsA scoping review was undertaken to address the
following question āwhat factors influence the risk of
developing Barrettās esophagus?ā Forty-six articles were
included in this review.
ResultsThe majority of articles reviewed were caseā
control or cohort studies. Samples sizes ranged from 68 to
84,606. Risk factors reported to be statistically significant
were divided into three categories: demographic, lifestyle
and clinical factors. Strongest risk factors identified
include: male gender, increasing age, white race, smoking,
obesity and gastro-esophageal reflux disease symptoms,
while some aspects of a personās diet appear to act as a
protective measure.
ConclusionRisk factors for BE are complex and need to
be considered by healthcare professionals when identifying
patients that could benefit from endoscopic eradication.
These results provide a stepping stone for the future
development of a risk prediction model