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Gastroesophageal reflux in relation to adenocarcinomas of the esophagus: a pooled analysis from the Barrett's and Esophageal Adenocarcinoma Consortium (BEACON).
[esophageal adenocarcinoma]
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
.
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
.
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
.
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
.
Diseases
Validation
Diseases presenting
"cancer"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
alpha-thalassemia
benign recurrent intrahepatic cholestasis
cadasil
canavan disease
carcinoma of the gallbladder
cholangiocarcinoma
coats disease
congenital adrenal hyperplasia
congenital diaphragmatic hernia
cowden syndrome
cushing syndrome
cutaneous mastocytosis
dedifferentiated liposarcoma
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erdheim-chester disease
erythropoietic protoporphyria
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
familial hypocalciuric hypercalcemia
familial mediterranean fever
gm1 gangliosidosis
heparin-induced thrombocytopenia
hereditary cerebral hemorrhage with amyloidosis
hirschsprung disease
hodgkin lymphoma, classical
inclusion body myositis
junctional epidermolysis bullosa
kabuki syndrome
kallmann syndrome
kindler syndrome
lamellar ichthyosis
liposarcoma
locked-in syndrome
lymphangioleiomyomatosis
monosomy 21
neuralgic amyotrophy
oculocutaneous albinism
oligodontia
oral submucous fibrosis
papillon-lefèvre syndrome
pendred syndrome
pleomorphic liposarcoma
primary effusion lymphoma
proteus syndrome
pyomyositis
pyruvate dehydrogenase deficiency
severe combined immunodeficiency
sneddon syndrome
systemic capillary leak syndrome
triple a syndrome
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
werner syndrome
wiskott-aldrich syndrome
wolf-hirschhorn syndrome
x-linked adrenoleukodystrophy
This symptom has already been validated