title: Non-steroidal anti-inflammatory drugs, lower oesophageal sphincter-relaxing drugs and oesophageal cancer. A case-control study.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  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.affiliation: Department of Surgery, Norfolk and Norwich University Hospital, Norwich, UK.
authors.forename: Satish
authors.initials: S
authors.lastname: Ranka
authors.forename: Jenny M
authors.initials: JM
authors.lastname: Gee
authors.forename: Ian T
authors.initials: IT
authors.lastname: Johnson
authors.forename: Jane
authors.initials: J
authors.lastname: Skinner
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Hart
authors.forename: Michael
authors.initials: M
authors.lastname: Rhodes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D002121:Calcium Channel Blockers / Q000008:administration & dosage*; D016022:Case-Control Studies; D004938:Esophageal Neoplasms / Q000453:epidemiology* / Q000209:etiology; D049630:Esophageal Sphincter, Lower / Q000187:drug effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D001993:Bronchodilator Agents; D002121:Calcium Channel Blockers