Dr Lindblad and colleagues from England studied the association between long term treatment with acid suppressing drugs and the risk of esophageal or gastric adenocarcinoma.
The investigators evaluated persons registered in the general practitioners research database in England during 1994 and 2001.
The investigative team used multivariable unconditional logistic regression to calculate odds ratios with 95% confidence intervals.
The team identified 287 patients with oesophageal adenocarcinoma, 195 with gastric cardia adenocarcinoma, and 327 with gastric non-cardia adenocarcinoma.
The team randomly sampled 10,000 control persons.
|Peptic ulcer indications were associated with a 4-fold increased risk|
Esophageal indications for long term acid suppression included reflux symptoms, esophagitis, Barrett's esophagus, or hiatal hernia.
The investigators found that esophageal indications rendered a 5-fold increased risk of esophageal adenocarcinoma.
However, the team observed no association among users with a group of other indications, including peptic ulcer and gastroduodenal symptoms.
Peptic ulcer indications included gastric ulcer, duodenal ulcer, or unspecified peptic ulcer.
The team noted that peptic ulcer indications were associated with a greater than 4-fold increased risk of gastric non-cardia adenocarcinoma among long term users.
No such association was found in those treated for a group of other indications.
Dr Lindblad's team concludes, “Long term pharmacological gastric acid suppression is a marker of increased risk of esophageal and gastric adenocarcinoma.”
“However, these associations are most likely explained by the underlying treatment indication being a risk factor for the cancer rather than an independent harmful effect of these agents per se.”