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Meta-Analysis
. 2010 Nov;32(10):1222-7.
doi: 10.1111/j.1365-2036.2010.04471.x. Epub 2010 Sep 23.

Meta-analysis: the association of oesophageal adenocarcinoma with symptoms of gastro-oesophageal reflux

J H Rubenstein  1 , J B Taylor
Affiliations
Meta-Analysis

Meta-analysis: the association of oesophageal adenocarcinoma with symptoms of gastro-oesophageal reflux

J H Rubenstein et al. Aliment Pharmacol Ther. 2010 Nov.

Abstract

Background: Endoscopic screening has been proposed for patients with symptoms of gastro-oesophageal reflux disease (GERD) in the hope of reducing mortality from oesophageal adenocarcinoma. Assessing the net benefits of such a strategy requires a precise understanding of the cancer risk in the screened population.

Aim: To estimate precisely the association between symptoms of GERD and oesophageal adenocarcinoma.

Methods: Systematic review and meta-analysis of population-based studies with strict ascertainment of exposure and outcomes.

Results: Five eligible studies were identified. At least weekly symptoms of GERD increased the odds of oesophageal adenocarcinoma fivefold (odds ratio = 4.92; 95% confidence interval = 3.90, 6.22), and daily symptoms increased the odds sevenfold (random effects summary odds ratio = 7.40, 95% confidence interval = 4.94, 11.1), each compared with individuals without symptoms or less frequent symptoms. Duration of symptoms was also associated with oesophageal adenocarcinoma, but with very heterogeneous results, and unclear thresholds.

Conclusions: Frequent GERD symptoms are strongly associated with oesophageal adenocarcinoma. These results should be useful in developing epidemiological models of the development of oesophageal adenocarcinoma, and in models of interventions aimed at reducing mortality from this cancer.

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Figures

Figure 1
Figure 1
Flow diagram of study selection.
Figure 2
Figure 2
Forrest plot of association of weekly GERD symptoms with oesophageal adenocarcinoma. Odds ratios are for symptoms at least weekly vs. no symptoms or symptoms less than weekly. Scale is logarithmic.
See this image and copyright information in PMC

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