Risk factors for the development of oesophageal adenocarcinoma in Barrett's oesophagus: a UK primary care retrospective nested case–control study

Cooper, Sheldon C.; Menon, Shyam; Nightingale, P; Trudgill, N

doi:10.1177/2050640614523596

Cited by 17 publications

(16 citation statements)

References 28 publications

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“…115 Further, the Northern Ireland Barrett's register reported an approximate 2-fold increased risk of progression from BE to EAC associated with tobacco smoking, 116 a finding confirmed in subsequent smaller cohorts. 117,118 Overall, it is plausible that tobacco smoking contributes to EAC development, given that tobacco is a carcinogen that causes DNA damage in Barrett's epithelium. 119 A recent US study of 81 samples associated tobacco smoking with DNA hypermethylation in esophageal tissues.…”

Section: Tobacco Smokingmentioning

confidence: 99%

The Epidemiology of Esophageal Adenocarcinoma

2018

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The incidence of esophageal adenocarcinoma (EAC) has increased in many Western countries and is higher in men than women. Some risk factors for EAC have been identified-mainly gastroesophageal reflux disease, Barrett's esophagus, obesity, and tobacco smoking. It is not clear whether interventions to address these factors can reduce risk of EAC, although some evidence exists for smoking cessation. Although consumption of alcohol is not associated with EAC risk, other exposures, such as physical activity, nutrition, and medication use, require further study. Genetic variants have been associated with risk for EAC, but their overall contribution is low. Studies are needed to investigate associations between risk factors and the molecular subtypes of EAC. The prognosis for patients with EAC has slightly improved, but remains poor-screening and surveillance trials of high-risk individuals are needed.

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Section: Tobacco Smokingmentioning

confidence: 99%

The Epidemiology of Esophageal Adenocarcinoma

2018

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“…In einer Fall-Kontroll-Studie entwickelten 55 Barrett-Patienten während eines Follow-ups von 17 743 Patientenjahren ein Adenokarzinom [46]. Daraus berechnete sich eine Karzinomprogressionsrate von 0,3 %/Jahr.…”

Section: Hintergrundunclassified

S3-Leitlinie – Diagnostik und Therapie der Plattenepithelkarzinome und Adenokarzinome des Ösophagus

et al. 2019

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“…In the PCCIU data, we found b2 agonists, such as salbutamol, were associated with increased risk of oesophageal cancer, results which are consistent with studies by Vaughan et al 16,17,19 Our PCCIU findings are also similar to a recent cohort study of progression from Barrett's oesophagus to oesophageal cancer in which associations were observed with b2 agonist (adjusted HR 1.27, 95% CI 0.68, 2.38) and steroid inhaler use (adjusted HR 2.11, 95% CI 1.12, 3.97), although that study contained a total of only 55 oesophageal cancer cases within their Barrett's oesophagus cohort. 30 The cause of the increased risk of oesophageal cancer with b2 agonist use in PCCIU is unknown. The lack of association in UK Biobank, the lack of dose response association, the association between other asthma medications (e.g., steroidbased) and oesophageal cancer risk provide evidence against a causal interpretation, particularly as several studies have shown marked increases in oesophageal cancer risk in asthma patients.…”

Section: Discussionmentioning

confidence: 99%

Medications that relax the lower oesophageal sphincter and risk of oesophageal cancer: An analysis of two independent population‐based databases

Spence

Busby

Murchie

et al. 2018

Intl Journal of Cancer

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Excessive lower oesophageal sphincter relaxation increases gastro-oesophageal acid reflux, an oesophageal adenocarcinoma risk factor. Medications that relax this sphincter (benzodiazepines, calcium channel blockers, nitrates, β2 agonists and xanthines) could promote cancer. These medications were investigated in two independent datasets. In the Scottish Primary Care Clinical Informatics Unit (PCCIU) database, a nested case-control study of oesophageal cancer was performed using GP prescription records. Conditional logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CIs) for medication use and oesophageal cancer. In UK Biobank, a cohort study was conducted using self-reported medication use. Cox regression was used to calculate hazard ratios (HRs) and 95% CIs for medication use and oesophageal cancer, and by tumour subtype. Overall, 1,979 oesophageal cancer patients were matched to 9,543 controls in PCCIU, and 355 of 475,768 participants developed oesophageal cancer in UK Biobank. None of the medications investigated were significantly associated with oesophageal cancer risk apart from β2 agonists, which were associated with increased oesophageal cancer risk in PCCIU (adjusted OR 1.38, 95% CI 1.12, 1.70) but not in UK Biobank (adjusted HR 1.21, 95% CI 0.70, 2.08). Medications that relax the lower oesophageal sphincter were not associated with oesophageal cancer, apart from β2 agonists. This increased cancer risk in β2 agonist users merits further investigation.

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Risk factors for the development of oesophageal adenocarcinoma in Barrett's oesophagus: a UK primary care retrospective nested case–control study

Abstract: In this nested case-control study of BO, male gender, increasing age, and increasing use of asthma drugs were associated with progression to OAC.

Cited by 17 publications

References 28 publications

The Epidemiology of Esophageal Adenocarcinoma

The Epidemiology of Esophageal Adenocarcinoma

S3-Leitlinie – Diagnostik und Therapie der Plattenepithelkarzinome und Adenokarzinome des Ösophagus

Medications that relax the lower oesophageal sphincter and risk of oesophageal cancer: An analysis of two independent population‐based databases

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