Is Non-Erosive GERD Linked to an Increased Incidence of Esophageal Adenocarcinoma?
BACKGROUND AND PURPOSE:
- Gastroesophageal reflux disease (GERD) with erosive esophagitis is a risk factor for esophageal adenocarcinoma
- Holmberg et al. (BMJ, 2023) assessed the incidence rate of esophageal adenocarcinoma among patients with non-erosive GERD compared with the general population
METHODS:
- Population based cohort study
- Population
- Adults undergoing endoscopy in Denmark, Finland, and Sweden from 1987 through 2019
- Exposures
- Non-erosive GERD: absence of esophagitis and any other esophageal diagnosis at endoscopy
- Erosive GERD: presence of esophagitis at endoscopy
- Study design
- Follow-up: Up to 31 years
- Standardized incidence ratios with 95% CIs were calculated by dividing the observed number of esophageal adenocarcinomas in each of the GERD cohorts by the expected number
- Expected number derived from the general populations in Denmark, Finland, and Sweden of the corresponding age, sex, and calendar period
- Primary outcome
- Incidence rate of esophageal adenocarcinoma
RESULTS:
- Non-erosive GERD: 285,811 patients | Erosive GERD: 200,745 patients
- Non-erosive GERD: 2,081,051 person-years of follow-up | Erosive GERD: 1,750,249 person-years
- Incidence of esophageal adenocarcinomas
- Non-erosive GERD: 228
- Incidence rate: 11.0 per 100,000 person-years
- Erosive GERD: 542
- Incidence rate: 31.0 per 100,000 person-years
- Non-erosive GERD: 228
- The incidence of esophageal adenocarcinomas in the non-erosive GERD cohort was similar to that of the general population
- Standardized incidence ratio 1.04 (95% CI, 0.91 to 1.18)
- The incidence in the non-erosive GERD cohort did not increase with longer follow-up
- For 15 to 31 years of follow-up: IR 1.07 (95% CI, 0.65 to 1.65)
- Erosive GERD cohort had an increased incidence of esophageal adenocarcinomas compared to the general population
- Effect more pronounced with longer follow-up
- Standardized incidence ratio 2.36 (95% CI, 2.17 to 2.57)
CONCLUSION:
- Patients with non-erosive GERD experience esophageal adenocarcinomas at similar rates to patients in the general population
- The authors state
This finding suggests that patients with confirmed non-erosive GORD are not susceptible to develop oesophageal adenocarcinoma and may not require repeated endoscopic examinations regarding assessment of cancer risk
Learn More – Primary Sources:
SPECIALTY AREAS
- Alerts
- Allergy And Immunology
- Cancer Screening
- Cardiology
- Dermatology
- Diabetes
- Endocrine
- ENT
- Evidence Matters
- General Internal Medicine
- Genetics
- GI
- GU
- Hematology
- ID
- Medical Legal
- Mental Health
- MSK
- Nephrology
- Neurology
- Now@PcMED
- Oncology
- PcMED Connect
- PrEP Resource Center
- Preventive Medicine
- Pulmonary
- Rheumatology
- Test Your Knowledge
- Vaccinations
- Women's Health
- Your Practice