Nonsteroidal Anti-inflammatory Drug Use Reduces Risk of Adenocarcinomas of the Esophagus and Esophagogastric Junction in a Pooled Analysis

Liao, Linda M., Vaughan, Thomas L., Corley, Douglas A., Cook, Michael B., Casson, Alan G., Kamangar, Farin, Abnet, Christian C., Risch, Harvey A., Giffen, Carol, Freedman, Neal D., Chow, Wong-Ho, Sadeghi, Shahram, Pandeya, Nirmala, Whiteman, David C., Murray, Liam J., Bernstein, Leslie, Gammon, Marilie D. and Wu, Anna H. (2012) Nonsteroidal Anti-inflammatory Drug Use Reduces Risk of Adenocarcinomas of the Esophagus and Esophagogastric Junction in a Pooled Analysis. Gastroenterology, 142 3: 442-U85. doi:10.1053/j.gastro.2011.11.019


Author Liao, Linda M.
Vaughan, Thomas L.
Corley, Douglas A.
Cook, Michael B.
Casson, Alan G.
Kamangar, Farin
Abnet, Christian C.
Risch, Harvey A.
Giffen, Carol
Freedman, Neal D.
Chow, Wong-Ho
Sadeghi, Shahram
Pandeya, Nirmala
Whiteman, David C.
Murray, Liam J.
Bernstein, Leslie
Gammon, Marilie D.
Wu, Anna H.
Title Nonsteroidal Anti-inflammatory Drug Use Reduces Risk of Adenocarcinomas of the Esophagus and Esophagogastric Junction in a Pooled Analysis
Journal name Gastroenterology   Check publisher's open access policy
ISSN 0016-5085
1528-0012
Publication date 2012-03
Sub-type Article (original research)
DOI 10.1053/j.gastro.2011.11.019
Volume 142
Issue 3
Start page 442
End page U85
Total pages 16
Place of publication Maryland Heights, MO, United States
Publisher WB Saunders
Collection year 2012
Language eng
Formatted abstract
Background & Aims: Regular use of aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) has been reported to reduce risks of esophageal adenocarcinoma (EAC) and esophagogastric junctional adenocarcinoma (EGJA). However, individual studies have been too small to accurately assess the effects of medication type, frequency, or duration of use. We performed a pooled analysis to investigate these associations.
Methods: We performed a pooled analysis of 6 population-based studies within the Barrett's and Esophageal Adenocarcinoma Consortium to evaluate the association between NSAID use and the risk of EAC and EGJA, using uniform exposure definitions. We collected information from 6 studies (5 case-control and 1 cohort), with a total of 1226 EAC and 1140 EGJA cases, on aspirin and/or NSAID use. Study-specific odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multivariate adjusted logistic regression models and then pooled using a random effects meta-analysis model.
Results:
Compared with nonusers, individuals who have used NSAIDs had a statistically significant reduced risk of EAC (OR, 0.68; 95% CI, 0.560.83); they also appeared to have a reduced risk of EGJA (OR, 0.83; 95% CI, 0.661.03). Similar reductions in risk were observed among individuals who took aspirin or nonaspirin NSAIDs. The highest levels of frequency (daily or more frequently) and duration (<10 years) of NSAID use were associated with an approximately 40% reduction in risk of EAC, with ORs of 0.56 (95% CI, 0.430.73; P trend <.001) and 0.63 (95% CI, 0.450.90; P trend =.04), respectively.
Conclusions:
Although reverse causation could, in part, explain the inverse association observed between NSAID use and EAC risk, our pooled analysis suggests a possible role for NSAIDs in prevention of adenocarcinomas of the esophagus and esophagogastric junction
Keyword Beacon
Esophageal Neoplasm
Stomach Cancer
Anti Inflammatory Agent
Selective Cyclooxygenase 2 Inhibition
Barretts esophagus
Gastric cancer
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Non HERDC
School of Public Health Publications
 
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Created: Wed, 09 Jan 2013, 15:42:12 EST by Geraldine Fitzgerald on behalf of School of Public Health