Summary Previous studies have suggested that gastroesophageal reflux disease (GERD) may be associated with the risk of squamous cancers of the larynx and esophagus; However, most of these studies have had methodological limitations or insufficient control for potential confounders. Methods We prospectively examined the association between GERD and esophageal adenocarcinoma (EADC), esophageal squamous cell carcinoma (ESCC), and laryngeal squamous cell carcinoma (LSCC) in 490,605 NIH - AARP Diet and Health Study cohort participants who were between 50 and 71 years old. age at the beginning of the study. Exposure to risk factors was obtained from the baseline questionnaire. GERD diagnosis was extracted among eligible participants by linking to Medicare diagnosis codes and then multiplied by Medicare-ineligible participants. Hazard ratios (HRs) and 95% CIs of GERD were calculated using Cox regression. Results From 1995 to 2011, we increased 931 EADC cases, 876 LSCC cases, and 301 ESCC cases in this cohort and estimated multivariable-adjusted HRs of 2.23 (95% CI, 1.72-2.90), 1.91 (95% CI, 1.24-2.94) and 1.99 (95% CI, 1.39-2.84) for EADC, LSCC, and ESCC, respectively. Associations were independent of sex, smoking, alcohol intake, and follow-up periods. We estimate that among the general population of the United States, 22.04% of people ages 50 to 71 had GERD. Using risk factor distributions for the United States from national survey data, it was estimated that 16.92% of LSCC cases and 17.32% of ESCC cases among people aged 50 to 71 years were associated with GERD. Conclusion GERD is a common gastrointestinal disorder, but future prospective studies are needed to replicate our findings. If replicated, they may inform clinical surveillance of GERD patients and suggest new avenues for the prevention of these malignancies. |
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Results from a large prospective study indicate that gastroesophageal reflux disease (GERD), which also causes heartburn symptoms, is linked to an increased risk of several cancers of the larynx (or larynx) and esophagus. The study was published early online in CANCER , a peer-reviewed journal of the American Cancer Society.
GERD, a gastrointestinal disorder that affects about 20 percent of American adults, occurs when stomach acid backs up into the esophagus, where it can cause tissue damage. Research indicates that this damage can put patients at risk of developing a type of cancer called esophageal adenocarcinoma.
To provide additional information about this link and potential links to other types of cancer, a team led by Christian C. Abnet, PhD, of the National Cancer Institute, part of the National Institutes of Health (NIH), examined data on 490,605 adults. inscribed. in the NIH-AARP Diet and Health Study, a prospective study that mailed questionnaires in 1995-1996 to 3.5 million AARP members, ages 50 to 71, living in California, Florida, Louisiana, New Jersey, North Carolina North or Pennsylvania. , or in the metropolitan areas of Atlanta, Georgia and Detroit, Michigan.
Using Medicare claims data, the researchers estimated that 24 percent of the participants had a history of GERD.
Over the next 16 years after participants joined the study, 931 patients developed adenocarcinoma of the esophagus , 876 developed squamous cell carcinoma of the larynx , and 301 developed squamous cell carcinoma of the esophagus .
People with GERD had approximately two times the risk of developing each of these cancers, and the elevated risk was similar in groups categorized by sex, smoking, and alcohol consumption. The researchers were able to replicate the results when they restricted the analyzes to the Medicare data subset of 107,258 adults.
The team estimated that about 17 percent of these cancers in the larynx and esophagus are associated with GERD.
"This study alone is not sufficient to result in specific actions by the public. Additional research is needed to replicate these findings and establish GERD as a risk factor for cancer and other diseases," said Dr. Abnet . "Future studies are needed to evaluate whether treatments targeting GERD symptoms will alter the apparent risks."
