title: Use of anti-inflammatory drugs and lower esophageal sphincter-relaxing drugs and risk of esophageal and gastric cancers.
abstract: 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.
authors.affiliation: Epidemiology and Biostatistics Department, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
authors.forename: Joan
authors.initials: J
authors.lastname: Fortuny
authors.forename: Christine C
authors.initials: CC
authors.lastname: Johnson
authors.forename: Kari
authors.initials: K
authors.lastname: Bohlke
authors.forename: Wong-Ho
authors.initials: WH
authors.lastname: Chow
authors.forename: Gene
authors.initials: G
authors.lastname: Hart
authors.forename: Gena
authors.initials: G
authors.lastname: Kucera
authors.forename: Urvi
authors.initials: U
authors.lastname: Mujumdar
authors.forename: Dennis
authors.initials: D
authors.lastname: Ownby
authors.forename: Karen
authors.initials: K
authors.lastname: Wells
authors.forename: Marianne Ulcickas
authors.initials: MU
authors.lastname: Yood
authors.forename: Lawrence S
authors.initials: LS
authors.lastname: Engel
mesh_terms: 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
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000928:Antidepressive Agents; D006634:Histamine H1 Antagonists