Reflux-promoting drugs may raise risk for esophageal adenocarcinoma.
NEW YORK, August 2 (Praxis Press) An increase in the incidence of esophageal adenocarcinoma was first reported in the 1970s, a time period during which drugs that relax the lower esophageal sphincter (LES) had gained widespread use. Lagergren and colleagues studied the association of upper gastrointestinal tract cancers and use of several classes of LES-relaxing drugs. The study included 189 subjects with esophageal adenocarcinoma, 262 with adenocarcinoma of the gastric cardia, 167 with esophageal squamous cell carcinoma, and 820 control subjects. When compared with patients who had never used LES-relaxing drugs, patients who used them daily for more than five years had an estimated incidence rate ratio of 3.8 for esophageal adenocarcinoma; this association was strongest for anticholinergic drugs. In contrast, no association was noted for adenocarcinoma of the gastric cardia or esophageal squamous cell carcinoma. The therapeutic benefits of LES-relaxing drugs may be slightly offset by an increased risk of esophageal adenocarcinoma.