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 25 November 2017

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News

Adenocarcinomas of the esophagus and gastric cardia are associated with GERD

Gastroesophageal reflux is associated with increased risk of adenocarcinoma of the esophagus and gastric cardia, and these risks remain elevated after antireflux surgery, claim researchers from Sweden and the USA.

News image

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The team investigated the risk of adenocarcinomas of the esophagus and gastric cardia in patients with gastroesophageal reflux disease (GERD), and also after antireflux surgery.

The findings of the study were reported in the December issue of Gastroenterology.

A cohort of 35,274 male and 31,691 female patients, with a discharge diagnosis of GERD, were identified in the Swedish Inpatient Register. An additional cohort of 6406 male and 4671 female patients who underwent antireflux surgery were included.

Follow-up was attained through record linkage with several nationwide registers.

Standardized incidence ratio (SIR) was used to estimate relative risk of upper gastrointestinal cancers, using the general Swedish population as reference.

After exclusion of the first year follow-up, 37 esophageal and 36 gastric cardia adenocarcinomas were observed among male patients who did not have surgery (SIR, 6.3 and 2.4, respectively).

More than 65,000 GERD patients were studied.
Gastroenterology

It was found that SIR for esophageal adenocarcinoma increased with follow-up time.

Among male patients who had undergone antireflux surgery, risks were also elevated (16 esophageal adenocarcinoma, SIR, 14.1; 15 gastric cardia adenocarcinomas, SIR, 5.3). The risks remained elevated with time after surgery.

The researchers found that the cancer risk pattern in women was similar to that for men, but the number of cases was much smaller.

Author Weiman Ye, of the Karolinska Institutet in Stockholm, Sweden, commented on behalf of the group, "Gastroesophageal reflux is strongly associated with the risk of esophageal adenocarcinoma, and to a lesser extent, with gastric cardia adenocarcinoma."

"The risk of developing adenocarcinomas of the esophagus and gastric cardia remains increased after antireflux surgery," it was concluded.

Gastroenterology 2001; 121: 1286-93
04 December 2001

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