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News

Adenocarcinoma of the esophagus or gastric cardia in individuals with GERD

In patients with GERD, an EGD is associated with reduced mortality from adenocarcinoma of the esophagus or gastric cardia, find researchers in the June issue of Gastrointestinal Endoscopy.

News image

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In this study, a research team from Seattle, Washington, assessed whether EGD reduces mortality from adenocarcinoma of the esophagus or gastric cardia in patients with GERD.

The researchers performed a case-control study.

They identified 245 cases of death caused by adenocarcinoma of the esophagus or gastric cardia, between 1995 and 1999, in which reflux was present.

They also selected 980 controls with reflux, but no death from adenocarcinoma. Controls were frequency matched for age, gender, and race. All the subjects were men.

Cases were significantly less likely to have had an EGD.
Gastrointestinal Endoscopy

The team compared the occurrences of EGD, from 1990 onward, were compared for cases and controls.

The researchers analyzed the data using logistic regression analysis, with adjustment for potential confounding factors.

They found that the cases were significantly less likely to have had an EGD, compared with controls (adjusted odds ratio 0.66).

The negative association was the same for any EGD performed within 1 to 8 years before diagnosis, as for a more recent EGD.

However, the team did not include controls for esophagectomy, or for nonfatal diagnosis of adenocarcinoma. They were, therefore, unable to establish whether EGD and reduced mortality are causally linked.

The team also determined that the risk of dying from adenocarcinoma was significantly lower for men with a diagnosis of GERD as an inpatient, compared to men with an outpatient diagnosis.

Dr David Kearney’s team concluded, “For patients with GERD, performing an EGD is associated with reduced mortality from adenocarcinoma of the esophagus or gastric cardia, but whether this is a causative association remains unclear”.

Gastrointest Endosc 2003; 57: 823-9
03 June 2003

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