GORD may increase risk of some cancers
- Gastroesophageal reflux disease (GERD) is very common in the United States, affecting up to 27.8% of the population.
- Studies have suggested a possible link between GERD and cancers of the larynx and Oesophagus.
- A recent study adds further evidence to these findings.
In a new study, researchers found evidence of a link between GORD and cancers of the larynx and Oesophagus. The study, which appears in the journal Cancer, adds to an existing body of evidence.
The researchers hope that, if their results are confirmed, they might “inform clinical surveillance of GORD patients and suggest new avenues for prevention of these malignancies.”
Symptoms of GORD
GORD is a type of chronic gastrointestinal disease that causes the contents of the stomach to rise into the Oesophagus.
Researchers estimate that GORD affects 18.1% to 27.8% of people in the U.S.
People with GORD may experience heartburn or regurgitation, as well as chest pains, nausea, trouble swallowing, or a persistent cough.
GORD occurs when a person’s lower Oesophageal sphincter weakens or relaxes at the wrong times. Having overweight or obesity, being pregnant, and smoking are each risk factors for GORD.
Researchers have linked GORD to laryngeal squamous cell carcinoma (LSCC), a type of cancer of the aerodigestive tract. This part of the body includes the organs and tissues of the respiratory tract and upper digestive tract.
The authors of the present study note that earlier findings have been inconsistent.
They explain that “Most previous studies have been limited by size, study design, or insufficient control for important potential confounders, [such as] tobacco use and alcohol consumption, limiting the strength of the inference.”
In addition, no studies had investigated the possible link between GERD and Oesophageal squamous cell carcinoma (ESCC), another aerodigestive tract cancer.
Extracting the data
To address this, the researchers conducted a prospective study, drawing on data from the NIH‐AARP Diet and Health Study, which began in 1990s, with questionnaires sent to members of the American Association of Retired Persons, or AARP.
The participants were aged 50–71 years and located throughout the U.S. The researchers made use of the responses from 490,605 participants, 92.6% of whom identified as non-Hispanic white.
The questionnaire asked about various risk factors related to GERD, such as alcohol consumption, tobacco use, diet, body shape, and medical issues.
The researchers then cross-checked this data with data from Medicare claims related to GORD and also estimated the presence of GORD for those not eligible for Medicare. Overall, the team estimated that 23.7% of the sample they analyzed had a history of GORD.
They then used data from state cancer registries to determine whether the participants had developed LSCC, ESCC, or a type of cancer called Oesophageal adenocarcinoma (EADC) over the following 16 years.
GORD and cancer
The researchers found that participants with GORD were twice as likely as those without it to develop LSCC, ESCC, or EADC in the 16 years after they had filled out the questionnaire.
This relationship was present even after taking into account potentially confounding factors, such as tobacco use and alcohol consumption.
Across the U.S., the researchers estimate that “16.92% of LSCC cases and 17.32% of ESCC cases among individuals aged 50–71 years” are associated with GORD.
However, as the scientists note, their study has some limitations. For example, they estimated the presence of GORD based on medical claims, which may not account for people who treat their GORD with over-the-counter medicine.
Also, the reliance on Medicare data meant that a significant number of participants had no record of GORD, so the researchers needed to extrapolate from the data available.
Dr. Christian C. Abnet, a senior investigator at the National Cancer Institute and the corresponding author of the study, acknowledges, “This study alone is not sufficient to result in specific actions by the public. Additional research is needed to replicate these findings and establish GORD as a risk factor for cancer and other diseases.”
“Future studies are needed to evaluate whether treatments aimed at GORD symptoms will alter the apparent risks.”