Metabolic syndrome, Barrett’s oesophagus, the risk of oesophageal adenocarcinoma, and statin treatment

Chrysoula Boutari, Stella-Maria Angelopoulou, Georgios Sfikas, Konstantinos Kaitanidis, Konstantinos Tziomalos, Vasilios G. Athyros



Barrett’s oesophagus (BO) is a proinflammatory condition principally induced by gastroesophageal reflux disease. There is a strong association between metabolic syndrome (MetS) and its components, mainly increased waist-to-hip ratio, hypertension, and hypertriglyceridaemia, with increased risk for BO and oesophageal adenocarcinoma. At present there are generally accepted preventive interventions that reduce the incidence of obesity (MetS)-associated oesophageal cancer. However, observational studies suggest that the combined use of a statin and aspirin is associated with significantly reduced incidence of cancer in patients with BO. Moreover, there appears to be a significant association between the use of statins and a reduced incidence of all oesophageal cancers, including esophageal adenocarcinoma, regardless of the presence of BO, obesity, or reflux disease. Thus, statins might have clinically important antineoplastic off-target effects that should be further explored in interventional studies. All the above suggest that it should be tested whether different statins or different doses are similarly effective in reducing the risk for BO and oesophageal adenocarcinoma.

Keywords: Metabolic syndrome, Barrett’s oesophagus, oesophageal adenocarcinoma, statins