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Aspirin and Nonsteroidal Anti-Inflammatory Drug Use and the Risk of Barrett's Esophagus.
[esophageal adenocarcinoma]
The
use
of
aspirin
and
nonsteroidal
anti-
inflammatory
drugs
(
NSAIDs
)
may
decrease
the
risk
of
esophageal
adenocarcinoma
;
however
,
it
is
unknown
where
these
agents
may
act
in
the
proposed
pathway
from
normal
mucosa
to
Barrett
's
esophagus
to
esophageal
adenocarcinoma
.
The
aim
of
the
study
was
to
evaluate
the
association
between
aspirin
and
NSAID
use
and
Barrett
's
esophagus
in
a
case-control
study
within
a
large
community-based
population
.
We
conducted
a
case-control
study
of
aspirin
/
NSAID
use
and
Barrett
's
esophagus
within
the
Kaiser
Permanente
Northern
California
population
.
Cases
had
a
new
diagnosis
of
Barrett
's
esophagus
between
October
2002
and
September
2005
;
controls
were
members
without
a
diagnosis
of
Barrett
's
esophagus
.
Persons
with
Barrett
's
esophagus
were
less
likely
to
use
aspirin
than
population
controls
[
odds
ratio
(
OR
)
0
.
59
,
95
Â
%
confidence
interval
(
CI
)
0
.
39
-
0
.
87
]
;
a
stronger
association
was
found
among
cases
and
controls
with
reflux
symptoms
(
OR
0
.
49
,
95
Â
%
CI
0
.
32
-
0
.
75
;
p
value
interaction
Â
=
Â
0
.
004
)
.
Similar
associations
were
found
with
the
use
of
either
aspirin
and
/
or
non-aspirin
NSAIDs
(
OR
0
.
53
,
95
Â
%
CI
0
.
35
-
0
.
81
)
,
although
NSAID
use
alone
was
not
significantly
associated
with
Barrett
's
esophagus
(
OR
0
.
74
,
95
Â
%
CI
0
.
47
-
1
.
16
)
.
The
strength
of
the
association
was
highest
among
persons
with
at
least
moderate
-
to
-
high
total
medication
intake
.
Regular
use
of
aspirin
or
NSAIDs
was
associated
with
a
decreased
risk
of
Barrett
's
esophagus
,
particularly
among
persons
with
gastroesophageal
reflux
disease
symptoms
.
These
findings
have
implications
for
chemoprevention
,
as
some
of
the
previously
described
protective
association
between
aspirin
/
NSAIDs
and
esophageal
adenocarcinoma
may
be
explained
by
events
that
occur
prior
to
the
development
of
Barrett
's
esophagus
.
Diseases
Validation
Diseases presenting
"particularly among persons with gastroesophageal reflux disease symptoms"
symptom
esophageal adenocarcinoma
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