Erosive, but Not Nonerosive, GERD Ups Esophageal CA Risk

Overall risk remains low; no increased risk for patients with nonerosive reflux

WEDNESDAY, April 25 (HealthDay News) -- Patients with gastroesophageal reflux disease with a history of esophagitis are at increased risk for esophageal adenocarcinoma, although the absolute risk is low, according to a study published in the May issue of Clinical Gastroenterology and Hepatology.

Rune Erichsen, M.D., from Aarhus University in Denmark, and colleagues analyzed data from 33,849 patients with reflux disease (52 percent men; median age, 59.3 years) identified in population-based Danish medical registries from 1996 to 2008. The observed adenocarcinoma incidence among patients with erosive and nonerosive disease was compared with the expected incidence for the general population.

The researchers found that 77 percent of participants (26,194) had erosive reflux disease, and over a mean follow-up of 7.4 years, 37 subsequently developed esophageal adenocarcinoma. After 10 years, the absolute risk was 0.24 percent. Compared with the expected incidence for the general population, the observed incidence among patients with erosive reflux disease was significantly increased (standardized incidence ratio, 2.2). After 4.5 years of follow-up, only one patient out of 7,655 patients with nonerosive reflux disease was diagnosed with esophageal adenocarcinoma (standardized incidence ratio, 0.3).

"Erosive reflux disease, but not nonerosive disease, increased the risk of esophageal adenocarcinoma, based on analysis of population-based Danish medical registries," the authors write. "Inflammation therefore might be an important factor in the progression from reflux to esophageal adenocarcinoma."

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