Most Esophageal Reflux Patients Face No Elevated Cancer Risk

A large-scale study across three Nordic countries has revealed that the majority of patients do not face an increased cancer risk, with elevated cancer risk observed only in individuals with gastroscopy-detected changes in their esophageal mucosa. //The findings are published in The BMJ by researchers at Karolinska Institutet (1^✔ ✔Trusted Source
Non-erosive gastro-oesophageal reflux disease and incidence of oesophageal adenocarcinoma in three Nordic countries: population based cohort study

Go to source). ­“This is a gratifying result since reflux disease is a very common condition and most patients are found to have a completely normal mucus membrane on gastroscopic examination,” says the study’s first author Dag Holmberg, researcher at the Department of Molecular Medicine and Surgery, Karolinska Institutet and resident doctor of surgery at Karolinska University Hospital in Sweden.

Esophageal Cancer Risk in Reflux Disease Patients with Normal Mucosa

In reflux disease, acidic stomach contents leak into the esophagus. This can sometimes cause inflammation in the esophageal mucus membrane (esophagitis), which is diagnosed via gastroscopy. It is common knowledge that reflux disease increases the risk of esophageal cancer, but what the cancer risk is for patients with normal mucosa has remained unknown.

The symptoms of reflux disease can come and go but generally persist, which means that many patients frequently seek medical attention and often undergo repeated gastroscopies to detect mucosal lesions or prodromal cancer.

The present study is based on national health data registries in Sweden, Denmark and Finland, and included over 285,000 individuals with reflux disease and no gastroscopic evidence of esophagitis. The patients were followed for up to 31 years and the researchers registered all cases of esophageal cancer.

The cancer risk was then compared with that for individuals from the general population matched by age and sex and at the same period in the three countries. No increased risk of esophageal cancer was observed in patients with reflux disease and a normal mucus membrane.

By way of comparison, the researchers also analysed the cancer risk in over 200,000 individuals with reflux disease and esophagitis. These people were at a clearly increased relative risk of developing esophageal cancer.

“We now intend to examine what factors other than esophagitis can be linked to tumor growth in people with reflux disease,” says the study’s last author Jesper Lagergren, professor of surgery at the Department of Molecular Medicine and Surgery, Karolinska Institutet, and consultant surgeon at Karolinska University Hospital.

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Reference:

1. Non-erosive gastro-oesophageal reflux disease and incidence of oesophageal adenocarcinoma in three Nordic countries: population based cohort study - (https://www.bmj.com/content/382/bmj-2023-076017)

Source-Eurekalert