Statin treatment and oesophageal cancer

A prospective open cohort study has examined and quantified the unintended risks and benefits of statins in a large representative primary care population over a six year period.

With respect to risk of oesophageal cancer and statin treatment

• risk of oesophageal cancer decreased in both men and women prescribed simvastatin (0.69, 0.50 to 0.94 and 0.82, 0.68 to 0.99, respectively)
• risk was also significantly decreased in men prescribed atorvastatin (0.73, 0.55 to 0.96). The hazard ratios for the other statins were of similar magnitude and all less than 1, but they did not reach statistical significance possibly because of small numbers
• direct comparison test showed no significant difference between the effects of individual statins in either men (P=0.76) or women (P=0.99)
• based on the 20% threshold for cardiovascular risk, for women the NNT with any statin to prevent one case of cardiovascular disease over five years was 37 (95% confidence interval 27 to 64) and for oesophageal cancer was 1266 (850 to 3460) and for men the respective values were 33 (24 to 57) and 1082 (711 to 2807)

Reference:

• 1) Hippisley-Cox J, Coupland C. Unintended effects of statins in men and women in England and Wales: population based cohort study using the QResearch database. BMJ 2010;340:c2197