TITLE

RISK OF EXTRA-OESOPHAGEAL MALIGNANCIES IN BARRETT'S OESOPHAGUS AND IN GASTRO-OESOPHAGEAL REFLUX

AUTHOR(S)
Solaymani-Dodaran, M.; Coupland, C.; Logan, R.F.A.
PUB. DATE
April 2003
SOURCE
Gut;Apr2003 Supplement 1, Vol. 52, pA45
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Introduction: The relationship between Barrett's oesophagus and extra-oesophageal malignancies (EOM) has been a matter of controversy. Some researchers have pointed out that the incidence of colon cancer is higher in Barrett patients while others have found no such association. The current study explores the relationship between Barrett's oesophagus and EOM in general and colon cancer in particular in 27 813 subjects in General Practice Research Database (GPRD). Methods: The mean follow-up experience was about 6 years and the study subjects constitute four groups: Barrett's oesophagus group (1677), oesophagitis group (6392), simple reflux group (6328), and normal group (13 416). Respectively the last three groups were 4/1, 4/1, and 8/1 matched to the Barrett group according to their GP practice, date of birth and sex. All malignancies occurring before or in the first year after the diagnosis of Barrett's, oesophagitis, or reflux were regarded as prevalent and excluded from the analysis. Risk of occurrence of an unrelated condition such as cataract was also explored for comparison. Number of visits to the GP was defined as a date on which there are both medical and drug records available and its confounding effects were control[ed. Hazard ratios were calculated using Cox-proportional hazard regression analysis. Results: A total of 2167 EOM, 260 colorectal cancer, and 1918 cataract diagnoses were identified in study subjects of which 1119, 113, and 853 cases were excluded respectively as being prevalent. The hazard ratios have been presented in the table after adjusting for age, sex, and number of visits to the GP. Conclusion: The risk of colorectal cancer was not specifically higher in any of these groups. There were small increases in risk of EOM in the Barrett's oesophagus, oesophagitis and reflux groups in comparison to the general population. The explanation for these increases is unclear but they may be mediated by smoking if smoking rates are increased in...
ACCESSION #
9747572

 

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