BACKGROUND AND AIMS: The incidence of oesophageal cancer has doubled in the last three decades. Non-steroidal anti-inflammatory drugs (NSAIDs) may be protective, whilst bronchodilators and calcium channel blockers that relax the lower oesophageal sphincter (LOS) may increase gastro-oesophageal reflux and the risk of oesophageal adenocarcinoma. We conducted a case-control study to examine the association between the use of NSAIDs and drugs which relax the LOS and the risk of oesophageal cancer. METHODS: In Norfolk, 411 patients with a primary neoplasm of the oesophagus or cardia were matched with 1,644 controls with non-melanotic skin lesions. Data on the use of NSAIDs, bronchodilators and calcium channel blockers was collected. RESULTS: Intake of NSAIDs was less in cases of oesophageal cancer as compared to the control group. The odds ratios (OR) and 95% confidence intervals (CI) for different NSAIDs were as follows: aspirin 0.35 (0.24-0.51); other NSAIDs 0.25 (0.16-0.40), and Cox-2 inhibitors 0.46 (0.20-0.94). LOS-relaxing drugs were consumed more frequently in cases of oesophageal cancer as compared to the controls. The OR for LOS-relaxing drugs was: inhaled bronchodilators 3.2 (95% CI 2.2-4.7); theophylline 1.9 (95% CI 1.3-5.1), and calcium channel blockers 2.4 (95% CI 1.2-5.0). CONCLUSION: Within the limitations of a case-control study using patients with non-melanotic skin lesions as controls, our results are consistent with the hypothesis that oesophageal cancer has a negative association with NSAID use, and a positive association with drugs that relax the LOS.
BACKGROUND AND AIMS: The incidence of oesophageal cancer has doubled in the last three decades. Non-steroidal anti-inflammatory drugs (NSAIDs) may be protective, whilst bronchodilators and calcium channel blockers that relax the lower oesophageal sphincter (LOS) may increase gastro-oesophageal reflux and the risk of oesophageal adenocarcinoma. We conducted a case-control study to examine the association between the use of NSAIDs and drugs which relax the LOS and the risk of oesophageal cancer. METHODS: In Norfolk, 411 patients with a primary neoplasm of the oesophagus or cardia were matched with 1,644 controls with non-melanotic skin lesions. Data on the use of NSAIDs, bronchodilators and calcium channel blockers was collected. RESULTS: Intake of NSAIDs was less in cases of oesophageal cancer as compared to the control group. The odds ratios (OR) and 95% confidence intervals (CI) for different NSAIDs were as follows: aspirin 0.35 (0.24-0.51); other NSAIDs 0.25 (0.16-0.40), and Cox-2 inhibitors 0.46 (0.20-0.94). LOS-relaxing drugs were consumed more frequently in cases of oesophageal cancer as compared to the controls. The OR for LOS-relaxing drugs was: inhaled bronchodilators 3.2 (95% CI 2.2-4.7); theophylline 1.9 (95% CI 1.3-5.1), and calcium channel blockers 2.4 (95% CI 1.2-5.0). CONCLUSION: Within the limitations of a case-control study using patients with non-melanotic skin lesions as controls, our results are consistent with the hypothesis that oesophageal cancer has a negative association with NSAID use, and a positive association with drugs that relax the LOS.
Authors: Linda M Liao; Thomas L Vaughan; Douglas A Corley; Michael B Cook; Alan G Casson; Farin Kamangar; Christian C Abnet; Harvey A Risch; Carol Giffen; Neal D Freedman; Wong-Ho Chow; Shahram Sadeghi; Nirmala Pandeya; David C Whiteman; Liam J Murray; Leslie Bernstein; Marilie D Gammon; Anna H Wu Journal: Gastroenterology Date: 2011-11-19 Impact factor: 22.682
Authors: Meira Epplein; Abraham M Y Nomura; Lynne R Wilkens; Brian E Henderson; Laurence N Kolonel Journal: Am J Epidemiol Date: 2009-07-07 Impact factor: 4.897