Use of Anti-Inflammatory Drugs and Lower Esophageal Sphincter-Relaxing Drugs and Risk of Esophageal and Gastric Cancers

Joan Fortuny, Christine C. Johnson, Kari Bohlke, Wong Ho Chow, Gene Hart, Gena Kucera, Urvi Mujumdar, Dennis Randall Ownby, Karen Wells, Marianne Ulcickas Yood, Lawrence S. Engel

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Background & Aims: The incidence of esophageal and gastric cardia adenocarcinoma has increased in Western countries in recent decades for largely unknown reasons. We investigated whether use of LES-relaxing drugs was related to an increased risk of esophageal and gastric cardia adenocarcinoma, and whether use of NSAIDs was related to a reduced risk of esophageal and gastric cancers. Methods: We examined these associations by using administrative databases in a case-control study in 2 integrated health care delivery systems. Cases were incident esophageal adenocarcinomas (n = 163) and squamous cell carcinomas (n = 114) and gastric cardia (n = 176) and non-cardia adenocarcinomas (n = 320), diagnosed between 1980-2002 in one health system and between 1993-2002 in the other. Matched controls (n = 3996) were selected. Complete prescription information was available for the study period. Results: Prescription of corticosteroids was associated with a decreased risk of esophageal adenocarcinoma (odds ratio [OR], 0.6; 95% confidence interval [CI], 0.4-0.9), esophageal squamous cell carcinoma (OR, 0.4; 95% CI, 0.2-0.6), and gastric non-cardia carcinoma (OR, 0.4, 95% CI, 0.3-0.6). Ever use of pharmacy-purchased aspirin was associated with 30%-60% decreased risks of the studied cancers. As a group, LES-relaxing drugs showed little evidence of association with increased risk of any esophageal or gastric cancer. Conclusions: Corticosteroid and aspirin use were associated with significantly decreased risks of esophageal and gastric cancer. LES-relaxing drugs as a group did not affect these risks, although we had limited power to assess individual drugs. The possibility that corticosteroids and aspirin might reduce esophageal cancer risk warrants further consideration.

Original languageEnglish (US)
JournalClinical Gastroenterology and Hepatology
Volume5
Issue number10
DOIs
StatePublished - Jan 1 2007

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Lower Esophageal Sphincter
Esophageal Neoplasms
Stomach Neoplasms
Anti-Inflammatory Agents
Adenocarcinoma
Pharmaceutical Preparations
Cardia
Stomach
Aspirin
Adrenal Cortex Hormones
Odds Ratio
Confidence Intervals
Prescriptions
Integrated Delivery of Health Care
Non-Steroidal Anti-Inflammatory Agents
Case-Control Studies
Squamous Cell Carcinoma
Databases
Carcinoma
Incidence

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Use of Anti-Inflammatory Drugs and Lower Esophageal Sphincter-Relaxing Drugs and Risk of Esophageal and Gastric Cancers. / Fortuny, Joan; Johnson, Christine C.; Bohlke, Kari; Chow, Wong Ho; Hart, Gene; Kucera, Gena; Mujumdar, Urvi; Ownby, Dennis Randall; Wells, Karen; Yood, Marianne Ulcickas; Engel, Lawrence S.

In: Clinical Gastroenterology and Hepatology, Vol. 5, No. 10, 01.01.2007.

Research output: Contribution to journalArticle

Fortuny, Joan ; Johnson, Christine C. ; Bohlke, Kari ; Chow, Wong Ho ; Hart, Gene ; Kucera, Gena ; Mujumdar, Urvi ; Ownby, Dennis Randall ; Wells, Karen ; Yood, Marianne Ulcickas ; Engel, Lawrence S. / Use of Anti-Inflammatory Drugs and Lower Esophageal Sphincter-Relaxing Drugs and Risk of Esophageal and Gastric Cancers. In: Clinical Gastroenterology and Hepatology. 2007 ; Vol. 5, No. 10.
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abstract = "Background & Aims: The incidence of esophageal and gastric cardia adenocarcinoma has increased in Western countries in recent decades for largely unknown reasons. We investigated whether use of LES-relaxing drugs was related to an increased risk of esophageal and gastric cardia adenocarcinoma, and whether use of NSAIDs was related to a reduced risk of esophageal and gastric cancers. Methods: We examined these associations by using administrative databases in a case-control study in 2 integrated health care delivery systems. Cases were incident esophageal adenocarcinomas (n = 163) and squamous cell carcinomas (n = 114) and gastric cardia (n = 176) and non-cardia adenocarcinomas (n = 320), diagnosed between 1980-2002 in one health system and between 1993-2002 in the other. Matched controls (n = 3996) were selected. Complete prescription information was available for the study period. Results: Prescription of corticosteroids was associated with a decreased risk of esophageal adenocarcinoma (odds ratio [OR], 0.6; 95{\%} confidence interval [CI], 0.4-0.9), esophageal squamous cell carcinoma (OR, 0.4; 95{\%} CI, 0.2-0.6), and gastric non-cardia carcinoma (OR, 0.4, 95{\%} CI, 0.3-0.6). Ever use of pharmacy-purchased aspirin was associated with 30{\%}-60{\%} decreased risks of the studied cancers. As a group, LES-relaxing drugs showed little evidence of association with increased risk of any esophageal or gastric cancer. Conclusions: Corticosteroid and aspirin use were associated with significantly decreased risks of esophageal and gastric cancer. LES-relaxing drugs as a group did not affect these risks, although we had limited power to assess individual drugs. The possibility that corticosteroids and aspirin might reduce esophageal cancer risk warrants further consideration.",
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AU - Fortuny, Joan

AU - Johnson, Christine C.

AU - Bohlke, Kari

AU - Chow, Wong Ho

AU - Hart, Gene

AU - Kucera, Gena

AU - Mujumdar, Urvi

AU - Ownby, Dennis Randall

AU - Wells, Karen

AU - Yood, Marianne Ulcickas

AU - Engel, Lawrence S.

PY - 2007/1/1

Y1 - 2007/1/1

N2 - Background & Aims: The incidence of esophageal and gastric cardia adenocarcinoma has increased in Western countries in recent decades for largely unknown reasons. We investigated whether use of LES-relaxing drugs was related to an increased risk of esophageal and gastric cardia adenocarcinoma, and whether use of NSAIDs was related to a reduced risk of esophageal and gastric cancers. Methods: We examined these associations by using administrative databases in a case-control study in 2 integrated health care delivery systems. Cases were incident esophageal adenocarcinomas (n = 163) and squamous cell carcinomas (n = 114) and gastric cardia (n = 176) and non-cardia adenocarcinomas (n = 320), diagnosed between 1980-2002 in one health system and between 1993-2002 in the other. Matched controls (n = 3996) were selected. Complete prescription information was available for the study period. Results: Prescription of corticosteroids was associated with a decreased risk of esophageal adenocarcinoma (odds ratio [OR], 0.6; 95% confidence interval [CI], 0.4-0.9), esophageal squamous cell carcinoma (OR, 0.4; 95% CI, 0.2-0.6), and gastric non-cardia carcinoma (OR, 0.4, 95% CI, 0.3-0.6). Ever use of pharmacy-purchased aspirin was associated with 30%-60% decreased risks of the studied cancers. As a group, LES-relaxing drugs showed little evidence of association with increased risk of any esophageal or gastric cancer. Conclusions: Corticosteroid and aspirin use were associated with significantly decreased risks of esophageal and gastric cancer. LES-relaxing drugs as a group did not affect these risks, although we had limited power to assess individual drugs. The possibility that corticosteroids and aspirin might reduce esophageal cancer risk warrants further consideration.

AB - Background & Aims: The incidence of esophageal and gastric cardia adenocarcinoma has increased in Western countries in recent decades for largely unknown reasons. We investigated whether use of LES-relaxing drugs was related to an increased risk of esophageal and gastric cardia adenocarcinoma, and whether use of NSAIDs was related to a reduced risk of esophageal and gastric cancers. Methods: We examined these associations by using administrative databases in a case-control study in 2 integrated health care delivery systems. Cases were incident esophageal adenocarcinomas (n = 163) and squamous cell carcinomas (n = 114) and gastric cardia (n = 176) and non-cardia adenocarcinomas (n = 320), diagnosed between 1980-2002 in one health system and between 1993-2002 in the other. Matched controls (n = 3996) were selected. Complete prescription information was available for the study period. Results: Prescription of corticosteroids was associated with a decreased risk of esophageal adenocarcinoma (odds ratio [OR], 0.6; 95% confidence interval [CI], 0.4-0.9), esophageal squamous cell carcinoma (OR, 0.4; 95% CI, 0.2-0.6), and gastric non-cardia carcinoma (OR, 0.4, 95% CI, 0.3-0.6). Ever use of pharmacy-purchased aspirin was associated with 30%-60% decreased risks of the studied cancers. As a group, LES-relaxing drugs showed little evidence of association with increased risk of any esophageal or gastric cancer. Conclusions: Corticosteroid and aspirin use were associated with significantly decreased risks of esophageal and gastric cancer. LES-relaxing drugs as a group did not affect these risks, although we had limited power to assess individual drugs. The possibility that corticosteroids and aspirin might reduce esophageal cancer risk warrants further consideration.

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