Reevaluation of gastroesophageal reflux disease as a risk factor for laryngeal cancer.
OBJECTIVE
The relationship between gastroesophageal reflux disease (GERD) and laryngeal cancer has not been fully elucidated. This case-control study investigates whether GERD increases the odds of developing these malignancies.


METHODS
Case-control study.


METHODS
Rates of GERD among cases of laryngeal cancer identified in the Veterans Health Administration outpatient care files (year 2000-2006) were compared with controls. Cases (N = 14,449) were frequency matched 1:1 with controls. Multivariate logistic regression was used to determine the association between GERD and cancer.


RESULTS
After adjusting for tobacco and/or alcohol use, there was no association between GERD and laryngeal cancer (adjusted odds ratio, 1.01; 95% confidence interval, 0.92-1.12, P =.780). Although an association was found when time from GERD diagnosis to malignancy was less than 3 months, it disappeared when this period was extended further.


CONCLUSIONS
In this population, there was no increased risk of laryngeal cancer among patients with GERD. However, in subsite analysis, a possible relationship between GERD and glottic cancer was observed. Reverse causality must be considered in future studies assessing the relationship between reflux and laryngeal cancer to limit misclassification bias.
Health Service Research and Development, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA. david.o.francis@vanderbilt.edu
David O
DO
Francis
Charles
C
Maynard
Ernest A
EA
Weymuller
Gayle
G
Reiber
Albert L
AL
Merati
Bevan
B
Yueh
D000368:Aged; D016022:Case-Control Studies; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors