S1036 Statin Use in Patients With Barrett’s Esophagus Is Associated With Reduced Need for Endoscopic Intervention: A Population-Based Study

Introduction: Barrett’s esophagus (BE) is a known precursor to esophageal adenocarcinoma. While the chemopreventive role of statins has been previously suggested, real-world data from large, nationally representative populations remain limited. Furthermore, the impact of statins on the need for endoscopic interventions—such as radiofrequency ablation and endoscopic mucosal resection—has not been well studied. Methods: We conducted a retrospective, population-based cohort study using the TriNetX U.S. Collaborative Network, which includes data from 67 healthcare organizations. Adults with BE were divided into 2 cohorts based on statin exposure: those with consistent statin use for at least 6 months and those without any statin exposure. Propensity score matching (1:1) was used to balance cohorts on demographics (age, sex, race, ethnicity), comorbidities (including cardiovascular disease, gastroesophageal reflux, and tobacco use), body mass index, and concurrent medication use (including aspirin and nonsteroidal anti-inflammatory drugs). The primary outcomes were the need for endoscopic intervention and the incidence of esophageal cancer. Secondary outcome included all-cause mortality. Analyses included hazard ratios (HR), Kaplan-Meier survival, and risk estimates over a 5-year follow-up. Results: Statin use was associated with lower risk of endoscopic intervention (HR 0.66; 95% confidence interval [CI] 0.59-0.72; P < 0.001) and esophageal cancer (HR 0.60; 95% CI 0.53-0.70; P < 0.001). All-cause mortality was also lower among statin users (HR 0.57; 95% CI 0.54-0.60; P < 0.001). Kaplan-Meier analysis confirmed significantly improved survival in statin users for all outcomes. Conclusion: In this large real-world analysis, consistent statin use in patients with BE was associated with significantly reduced risks of esophageal cancer, endoscopic therapy, and overall mortality. These findings highlight the value of statins as a potential chemopreventive agent and demonstrate the utility of population-level data in supporting real-world treatment decisions.