Gastroesophageal reflux in relation to adenocarcinomas of the esophagus: a pooled analysis from the Barrett's and Esophageal Adenocarcinoma Consortium (BEACON).
<h4>Background</h4>Previous studies have evidenced an association between gastroesophageal reflux and esophageal adenocarcinoma (EA). It is unknown to what extent these associations vary by population, age, sex, body mass index, and cigarette smoking, or whether duration and frequency of...
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Public Library of Science (PLoS)
2014-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0103508 |
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| author | Michael B Cook Douglas A Corley Liam J Murray Linda M Liao Farin Kamangar Weimin Ye Marilie D Gammon Harvey A Risch Alan G Casson Neal D Freedman Wong-Ho Chow Anna H Wu Leslie Bernstein Olof Nyrén Nirmala Pandeya David C Whiteman Thomas L Vaughan |
| author_facet | Michael B Cook Douglas A Corley Liam J Murray Linda M Liao Farin Kamangar Weimin Ye Marilie D Gammon Harvey A Risch Alan G Casson Neal D Freedman Wong-Ho Chow Anna H Wu Leslie Bernstein Olof Nyrén Nirmala Pandeya David C Whiteman Thomas L Vaughan |
| author_sort | Michael B Cook |
| collection | DOAJ |
| description | <h4>Background</h4>Previous studies have evidenced an association between gastroesophageal reflux and esophageal adenocarcinoma (EA). It is unknown to what extent these associations vary by population, age, sex, body mass index, and cigarette smoking, or whether duration and frequency of symptoms interact in predicting risk. The Barrett's and Esophageal Adenocarcinoma Consortium (BEACON) allowed an in-depth assessment of these issues.<h4>Methods</h4>Detailed information on heartburn and regurgitation symptoms and covariates were available from five BEACON case-control studies of EA and esophagogastric junction adenocarcinoma (EGJA). We conducted single-study multivariable logistic regressions followed by random-effects meta-analysis. Stratified analyses, meta-regressions, and sensitivity analyses were also conducted.<h4>Results</h4>Five studies provided 1,128 EA cases, 1,229 EGJA cases, and 4,057 controls for analysis. All summary estimates indicated positive, significant associations between heartburn/regurgitation symptoms and EA. Increasing heartburn duration was associated with increasing EA risk; odds ratios were 2.80, 3.85, and 6.24 for symptom durations of <10 years, 10 to <20 years, and ≥20 years. Associations with EGJA were slighter weaker, but still statistically significant for those with the highest exposure. Both frequency and duration of heartburn/regurgitation symptoms were independently associated with higher risk. We observed similar strengths of associations when stratified by age, sex, cigarette smoking, and body mass index.<h4>Conclusions</h4>This analysis indicates that the association between heartburn/regurgitation symptoms and EA is strong, increases with increased duration and/or frequency, and is consistent across major risk factors. Weaker associations for EGJA suggest that this cancer site has a dissimilar pathogenesis or represents a mixed population of patients. |
| format | Article |
| id | doaj-art-17c9c251bcb142808d10efd9761c6eb7 |
| institution | OA Journals |
| issn | 1932-6203 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Public Library of Science (PLoS) |
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| series | PLoS ONE |
| spelling | doaj-art-17c9c251bcb142808d10efd9761c6eb72025-08-20T02:22:49ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-0197e10350810.1371/journal.pone.0103508Gastroesophageal reflux in relation to adenocarcinomas of the esophagus: a pooled analysis from the Barrett's and Esophageal Adenocarcinoma Consortium (BEACON).Michael B CookDouglas A CorleyLiam J MurrayLinda M LiaoFarin KamangarWeimin YeMarilie D GammonHarvey A RischAlan G CassonNeal D FreedmanWong-Ho ChowAnna H WuLeslie BernsteinOlof NyrénNirmala PandeyaDavid C WhitemanThomas L Vaughan<h4>Background</h4>Previous studies have evidenced an association between gastroesophageal reflux and esophageal adenocarcinoma (EA). It is unknown to what extent these associations vary by population, age, sex, body mass index, and cigarette smoking, or whether duration and frequency of symptoms interact in predicting risk. The Barrett's and Esophageal Adenocarcinoma Consortium (BEACON) allowed an in-depth assessment of these issues.<h4>Methods</h4>Detailed information on heartburn and regurgitation symptoms and covariates were available from five BEACON case-control studies of EA and esophagogastric junction adenocarcinoma (EGJA). We conducted single-study multivariable logistic regressions followed by random-effects meta-analysis. Stratified analyses, meta-regressions, and sensitivity analyses were also conducted.<h4>Results</h4>Five studies provided 1,128 EA cases, 1,229 EGJA cases, and 4,057 controls for analysis. All summary estimates indicated positive, significant associations between heartburn/regurgitation symptoms and EA. Increasing heartburn duration was associated with increasing EA risk; odds ratios were 2.80, 3.85, and 6.24 for symptom durations of <10 years, 10 to <20 years, and ≥20 years. Associations with EGJA were slighter weaker, but still statistically significant for those with the highest exposure. Both frequency and duration of heartburn/regurgitation symptoms were independently associated with higher risk. We observed similar strengths of associations when stratified by age, sex, cigarette smoking, and body mass index.<h4>Conclusions</h4>This analysis indicates that the association between heartburn/regurgitation symptoms and EA is strong, increases with increased duration and/or frequency, and is consistent across major risk factors. Weaker associations for EGJA suggest that this cancer site has a dissimilar pathogenesis or represents a mixed population of patients.https://doi.org/10.1371/journal.pone.0103508 |
| spellingShingle | Michael B Cook Douglas A Corley Liam J Murray Linda M Liao Farin Kamangar Weimin Ye Marilie D Gammon Harvey A Risch Alan G Casson Neal D Freedman Wong-Ho Chow Anna H Wu Leslie Bernstein Olof Nyrén Nirmala Pandeya David C Whiteman Thomas L Vaughan Gastroesophageal reflux in relation to adenocarcinomas of the esophagus: a pooled analysis from the Barrett's and Esophageal Adenocarcinoma Consortium (BEACON). PLoS ONE |
| title | Gastroesophageal reflux in relation to adenocarcinomas of the esophagus: a pooled analysis from the Barrett's and Esophageal Adenocarcinoma Consortium (BEACON). |
| title_full | Gastroesophageal reflux in relation to adenocarcinomas of the esophagus: a pooled analysis from the Barrett's and Esophageal Adenocarcinoma Consortium (BEACON). |
| title_fullStr | Gastroesophageal reflux in relation to adenocarcinomas of the esophagus: a pooled analysis from the Barrett's and Esophageal Adenocarcinoma Consortium (BEACON). |
| title_full_unstemmed | Gastroesophageal reflux in relation to adenocarcinomas of the esophagus: a pooled analysis from the Barrett's and Esophageal Adenocarcinoma Consortium (BEACON). |
| title_short | Gastroesophageal reflux in relation to adenocarcinomas of the esophagus: a pooled analysis from the Barrett's and Esophageal Adenocarcinoma Consortium (BEACON). |
| title_sort | gastroesophageal reflux in relation to adenocarcinomas of the esophagus a pooled analysis from the barrett s and esophageal adenocarcinoma consortium beacon |
| url | https://doi.org/10.1371/journal.pone.0103508 |
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