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. 2006 Nov;55(11):1538-44.
doi: 10.1136/gut.2005.086579. Epub 2006 Jun 19.

Gastric acid suppression and risk of oesophageal and gastric adenocarcinoma: a nested case control study in the UK

L A García Rodríguez  1 , J Lagergren, M Lindblad
Affiliations

Gastric acid suppression and risk of oesophageal and gastric adenocarcinoma: a nested case control study in the UK

L A García Rodríguez et al. Gut. 2006 Nov.

Abstract

Background: Gastric acid suppressing drugs (that is, histamine(2) receptor antagonists and proton pump inhibitors) could affect the risk of oesophageal or gastric adenocarcinoma but few studies are available.

Aims: To study the association between long term treatment with acid suppressing drugs and the risk of oesophageal or gastric adenocarcinoma.

Patients: Persons registered in the general practitioners research database in the UK and aged 40-84 years during the period 1994-2001.

Methods: Population based nested case control study. Multivariable unconditional logistic regression was used to calculate odds ratios (ORs) with 95% confidence intervals (CI).

Results: In 4 340 207 person years of follow up, 287 patients with oesophageal adenocarcinoma, 195 with gastric cardia adenocarcinoma, and 327 with gastric non-cardia adenocarcinoma were identified, and 10 000 control persons were randomly sampled. "Oesophageal" indication for long term acid suppression (that is, reflux symptoms, oesophagitis, Barrett's oesophagus, or hiatal hernia) rendered a fivefold increased risk of oesophageal adenocarcinoma (odds ratio (OR) 5.42 (95% confidence interval (CI) 3.13-9.39)) while no association was observed among users with a group of other indications, including peptic ulcer and "gastroduodenal symptoms" (that is, gastritis, dyspepsia, indigestion, and epigastric pain) (OR 1.74 (95% CI 0.90-3.34)). "Peptic ulcer" indication (that is, gastric ulcer, duodenal ulcer, or unspecified peptic ulcer) was associated with a greater than fourfold increased risk of gastric non-cardia adenocarcinoma among long term users (OR 4.66 (95% CI 2.42-8.97)) but no such association was found in those treated for a group of other indications (that is, "oesophageal" or "gastroduodenal symptoms") (OR 1.18 (95% CI 0.60-2.32)).

Conclusions: Long term pharmacological gastric acid suppression is a marker of increased risk of oesophageal 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.

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Conflict of interest statement

Conflict of interest: None declared.

Comment in

References

    1. Devesa S S, Blot W J, Fraumeni J F., Jr Changing patterns in the incidence of esophageal and gastric carcinoma in the United States. Cancer 1998832049–2053. - PubMed
    1. Bollschweiler E, Wolfgarten E, Gutschow C.et al Demographic variations in the rising incidence of esophageal adenocarcinoma in white males. Cancer 200192549–555. - PubMed
    1. Hansson L E, Sparen P, Nyren O. Increasing incidence of both major histological types of esophageal carcinomas among men in Sweden. Int J Cancer 199354402–407. - PubMed
    1. Parkin D M. Global cancer statistics in the year 2000. Lancet Oncol 20012533–543. - PubMed
    1. Enzinger P C, Mayer R J. Esophageal cancer. N Engl J Med 20033492241–2252. - PubMed

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