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GERD does not boost cancer risk for most people

Acid reflux occurs with stomach acid splashes up into the foodpipe and inflames the lining. Source – Mayo Clinic

CANCER DIGEST – Sept. 16, 2023 – A large long-running Swedish study of gastroesophageal reflux disease (GERD) has found no increased risk of esophageal cancer in the majority of people with the disease who do not have damage to their esophagus.

"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 in a press release. He is a researcher at the Department of Molecular Medicine and Surgery, Karolinska Institutet and resident doctor of surgery at Karolinska University Hospital in Sweden.

GERD is a common disease that occurs in 20 percent of the population of industrialized countries, according to the authors. It results from stomach acid bubbling up into the throat, commonly described as heartburn. When this occurs several times a week over a period of years, it can cause damage or erosion of the mucus membrane protecting the throat tissue.

The study examined data from the national health data registries in Sweden, Denmark and Finland, and followed 485,000 people with reflux disease for up to 31 years. All cases of esophageal cancer were registered. The results appear in the September 2023 journal The BMJ (British Medical Journal)

The researchers then compared the cancer risk of those 285,000 people with GERD but no erosion of the esophageal mucus membrane to 200,000 similar people matched by age and sex without GERD over the same period. In addition the researchers examined the data of 200,745 patients with GERD who did have damage to the mucus membrane.

They found no increased risk of cancer in those GERD patients who also had normal mucus membrane upon endoscopic examination compared to people without GERD. An endoscope is a device that inserts a tiny camera into a person’s throat to visually examine the tissue. Among patients with GERD and esophageal damage the risk of cancer was significantly higher.

The implication of the study is that for patients who experience frequent heartburn and have no damage to the mucus membrane as examined with endoscopy need not have frequent subsequent endoscopic examines to monitor for cancer. People with esophagitis, an inflammation of the mucus membrane, however, should continue to be monitored for development of cancer.

Sources: Karolinska Institutet press release and The BMJ


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