Use of anti-inflammatory drugs and lower esophageal sphincter-relaxing drugs and risk of esophageal and gastric cancers.
OBJECTIVE
The incidence of esophageal and gastric cardia adenocarcinoma has increased in Western countries in recent decades for largely unknown reasons. We investigated whether use of LES-relaxing drugs was related to an increased risk of esophageal and gastric cardia adenocarcinoma, and whether use of NSAIDs was related to a reduced risk of esophageal and gastric cancers.


METHODS
We examined these associations by using administrative databases in a case-control study in 2 integrated health care delivery systems. Cases were incident esophageal adenocarcinomas (n = 163) and squamous cell carcinomas (n = 114) and gastric cardia (n = 176) and non-cardia adenocarcinomas (n = 320), diagnosed between 1980-2002 in one health system and between 1993-2002 in the other. Matched controls (n = 3996) were selected. Complete prescription information was available for the study period.


RESULTS
Prescription of corticosteroids was associated with a decreased risk of esophageal adenocarcinoma (odds ratio [OR], 0.6; 95% confidence interval [CI], 0.4-0.9), esophageal squamous cell carcinoma (OR, 0.4; 95% CI, 0.2-0.6), and gastric non-cardia carcinoma (OR, 0.4, 95% CI, 0.3-0.6). Ever use of pharmacy-purchased aspirin was associated with 30%-60% decreased risks of the studied cancers. As a group, LES-relaxing drugs showed little evidence of association with increased risk of any esophageal or gastric cancer.


CONCLUSIONS
Corticosteroid and aspirin use were associated with significantly decreased risks of esophageal and gastric cancer. LES-relaxing drugs as a group did not affect these risks, although we had limited power to assess individual drugs. The possibility that corticosteroids and aspirin might reduce esophageal cancer risk warrants further consideration.
Fortuny
Joan
J
Epidemiology and Biostatistics Department, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Johnson
Christine C
CC
Bohlke
Kari
K
Chow
Wong-Ho
WH
Hart
Gene
G
Kucera
Gena
G
Mujumdar
Urvi
U
Ownby
Dennis
D
Wells
Karen
K
Yood
Marianne Ulcickas
MU
Engel
Lawrence S
LS
D000230:Adenocarcinoma / Q000139:chemically induced / Q000453:epidemiology / Q000473:pathology; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D000928:Antidepressive Agents / Q000009:adverse effects*; D002294:Carcinoma, Squamous Cell / Q000139:chemically induced / Q000453:epidemiology / Q000473:pathology; D004938:Esophageal Neoplasms / Q000139:chemically induced* / Q000453:epidemiology / Q000473:pathology; D004947:Esophagus / Q000187:drug effects / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006634:Histamine H1 Antagonists / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008297:Male; D009119:Muscle Contraction / Q000187:drug effects*; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000139:chemically induced* / Q000453:epidemiology / Q000473:pathology; D014481:United States / Q000453:epidemiology
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000928:Antidepressive Agents; D006634:Histamine H1 Antagonists