title: Gastric reflux is an independent risk factor for laryngopharyngeal carcinoma.
abstract: BACKGROUND
  Gastric reflux can reach into the upper airway, inducing cellular damage in the epithelial lining. This condition is believed to be a risk factor for development of laryngopharyngeal squamous cell carcinoma (LPSCC), although the literature is conflicting.
  
  
  METHODS
  To better clarify this relationship, we assessed the association of self-reported heartburn history and medication use among 631 patients with LPSCCs and 1234 control subjects (frequency-matched on age, gender, and town of residence) enrolled as part of a population-based case-control study of head and neck squamous cell carcinoma in the greater Boston area.
  
  
  RESULTS
  After adjusting for age, gender, race, smoking, alcohol consumption, HPV16 seropositivity, education, and body mass index, subjects reporting a history of frequent heartburn and who were neither a heavy smoker nor heavy drinker had a significantly elevated risk of LPSCCs [OR, 1.78; 95% confidence interval (CI), 1.00-3.16]. Among those with a history of heartburn, there was an inverse association between antacid use and LPSCCs relative to those never taking heartburn medication (OR, 0.59; 95% CI, 0.38-0.93) that remained consistent when analyzed by smoking/drinking status, HPV16 status, or by primary tumor site.
  
  
  CONCLUSIONS
  Our data show that gastric reflux is an independent risk factor for squamous cancers of the pharynx and larynx. Further studies are needed to clarify the possible chemopreventive role of antacid use for patients with gastric reflux.
  
  
  CONCLUSIONS
  Elucidation of additional risk factors for head and neck cancer can allow for risk stratification and inform surveillance of high-risk patients.
authors.affiliation: Department of Epidemiology, Brown University, Providence, RI 02912, USA.
authors.forename: Scott M
authors.initials: SM
authors.lastname: Langevin
authors.forename: Dominique S
authors.initials: DS
authors.lastname: Michaud
authors.forename: Carmen J
authors.initials: CJ
authors.lastname: Marsit
authors.forename: Heather H
authors.initials: HH
authors.lastname: Nelson
authors.forename: Ariel E
authors.initials: AE
authors.lastname: Birnbaum
authors.forename: Melissa
authors.initials: M
authors.lastname: Eliot
authors.forename: Brock C
authors.initials: BC
authors.lastname: Christensen
authors.forename: Michael D
authors.initials: MD
authors.lastname: McClean
authors.forename: Karl T
authors.initials: KT
authors.lastname: Kelsey
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000150:complications*; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000209:etiology*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010610:Pharyngeal Neoplasms / Q000150:complications*; D011379:Prognosis; D012307:Risk Factors