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 â‰¥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 "gastroesophageal reflux" symptom

22q11.2 deletion syndrome

alpha-thalassemia

congenital diaphragmatic hernia

esophageal adenocarcinoma

neonatal adrenoleukodystrophy

This symptom has already been validated