Chemoprevention of Oesophageal Squamous-Cell Carcinoma and Adenocarcinoma: A Multicentre Retrospective Cohort Study.

Abstract

BACKGROUND:

Oesophageal cancer comprises 2 different histological variants: oesophageal squamous-cell carcinoma (ESCC) and adenocarcinoma (EAC). While there are multiple therapeutic options for both types, patients with advanced or metastatic oesophageal cancer still suffer from poor prognosis.

AIMS:

The study aimed to examine the association between the risk of oesophageal cancer and medications and to estimate the chemopreventive effects of commonly used drugs.

METHODS:

A multicentre retrospective cohort study was conducted using data from 9 hospital databases of hospitalized patients between 2014 and 2019. The primary outcomes were ESCC and EAC. The association of oesophageal cancer with drug use and clinical factors was evaluated. Odds ratios (ORs) were adjusted for age, sex, Charlson comorbidity index scores, and smoking with/without gastro-oesophageal reflux disease.

RESULTS:

The use of proton pump inhibitors (PPIs) (adjusted OR [aOR] 0.48, p < 0.0001), aspirin (aOR 0.32, p < 0.0001), cyclooxygenase-2 inhibitor (COX2I) (aOR 0.70, p = 0.0005), steroid (aOR 0.19, p < 0.0001), statin (aOR 0.43, p < 0.0001), and metformin (aOR 0.42, p < 0.0001) was associated with a lower risk of ESCC than that in non-use. The use of aspirin (aOR 0.33, p = 0.0006) and steroids (aOR 0.54, p = 0.022) was associated with a lower risk of EAC than that in non-use.

CONCLUSION:

COX2Is, statins, metformin, and PPIs could help in prevention of ESCC, and aspirin and steroids may be chemopreventive for both types of oesophageal cancer.

• Authors: Junya Arai, Ryota Niikura, Yoku Hayakawa, Takuya Kawahara, Tetsuro Honda, Kenkei Hasatani, Naohiro Yoshida, Tsutomu Nishida, Tetsuya Sumiyoshi, Shu Kiyotoki, Takashi Ikeya, Masahiro Arai, Nobumi Suzuki, Yosuke Tsuji, Atsuo Yamada, Takashi Kawai, Kazuhiko Koike
• Journal: Digestion (Digestion) Vol. 103 Issue 3 Pg. 192-204 ( 2022) ISSN: 1421-9867 [Electronic] Switzerland
• PMID: 34929693 (Publication Type: Journal Article, Multicenter Study)
• Copyright: © 2021 The Author(s). Published by S. Karger AG, Basel.

Chemical References

• Hydroxymethylglutaryl-CoA Reductase Inhibitors
• Proton Pump Inhibitors
• Metformin
• Aspirin

Topics

• Adenocarcinoma (epidemiology, etiology, prevention & control)
• Aspirin (therapeutic use)
• Case-Control Studies
• Chemoprevention
• Esophageal Neoplasms (epidemiology, etiology, prevention & control)
• Esophageal Squamous Cell Carcinoma (prevention & control)
• Humans
• Hydroxymethylglutaryl-CoA Reductase Inhibitors (therapeutic use)
• Metformin (therapeutic use)
• Proton Pump Inhibitors (therapeutic use)
• Retrospective Studies
• Risk Factors