| Summary: | <i>Purpose</i>: To investigate the association between statin use and stomach cancer incidence in individuals with hypercholesterolemia. <i>Materials and methods</i>: To examine the cumulative effect of statins, we defined a statin user as one who used statins during 2002−2003 at baseline. Statin users were further classified into high and low users according to the medication possession rate. Statin non-users consisted of participants who had never used statins during the entire period of 2002−2015, despite having hypercholesterolemia (total cholesterol level ≥250 mg/dL at baseline). Ultimately, 17,737 statin users and 13,412 statin non-users were used in the analysis. We performed survival analyses, considering the diagnosis of stomach cancer as an event of interest. <i>Results</i>: Median follow-up duration was 12.9 years. The cumulative incidence rates of stomach cancer were lowest in high users (1.90% in men and 0.98% in women). Compared to non-users, hazard ratios (95% confidential intervals) for stomach cancer of low users and high users were 0.953 (0.755−1.203) and 0.526 (0.399−0.693) in men and 0.629 (0.457−0.865) and 0.370 (0.256−0.535) in women, respectively, after adjusting for possible confounders. <i>Conclusions</i>: We observed an inverse association between statin use and stomach cancer incidence in participants with hypercholesterolemia.
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