title: Nonsteroidal Anti-Inflammatory Drug Use is Not Associated With Reduced Risk of Barrett's Esophagus.
abstract: Regular use of nonsteroidal anti-inflammatory drugs (NSAIDs) is associated with a reduced risk of esophageal adenocarcinoma. Epidemiological studies examining the association between NSAID use and the risk of the precursor lesion, Barrett's esophagus, have been inconclusive.
  
  
  
  We analyzed pooled individual-level participant data from six case-control studies of Barrett's esophagus in the Barrett's and Esophageal Adenocarcinoma Consortium (BEACON). We compared medication use from 1,474 patients with Barrett's esophagus separately with two control groups: 2,256 population-based controls and 2,018 gastroesophageal reflux disease (GERD) controls. Study-specific odds ratio (OR) and 95% confidence intervals (CI) were estimated using multivariable logistic regression models and were combined using a random-effects meta-analytic model.
  
  
  
  Regular (at least once weekly) use of any NSAIDs was not associated with the risk of Barrett's esophagus (vs. population-based controls, adjusted OR=1.00, 95% CI=0.76-1.32, I2=61%; vs. GERD controls, adjusted OR=0.99, 95% CI=0.82-1.19, I2=19%). Similar null findings were observed among individuals who took aspirin or non-aspirin NSAIDs. We also found no association with highest levels of frequency (at least daily use) and duration (≥5 years) of NSAID use. There was evidence of moderate between-study heterogeneity; however, associations with NSAID use remained non-significant in "leave-one-out" sensitivity analyses.
  
  
  
  Use of NSAIDs was not associated with the risk of Barrett's esophagus. The previously reported inverse association between NSAID use and esophageal adenocarcinoma may be through reducing the risk of neoplastic progression in patients with Barrett's esophagus.
authors: Department of Medicine, Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, Texas, USA.|Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas, USA.
authors: Aaron P
authors: AP
authors: Thrift
authors: Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland.
authors: Lesley A
authors: LA
authors: Anderson
authors: Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland.
authors: Liam J
authors: LJ
authors: Murray
authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA.
authors: Michael B
authors: MB
authors: Cook
authors: Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA.
authors: Nicholas J
authors: NJ
authors: Shaheen
authors: Center for Clinical Management Research, Ann Arbor Veterans Affairs Medical Center, Ann Arbor, Michigan, USA.|Barrett's Esophagus Program, Division of Gastroenterology, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA.
authors: Joel H
authors: JH
authors: Rubenstein
authors: Department of Medicine, Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, Texas, USA.|Department of Medicine, Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, Texas, USA.
authors: Hashem B
authors: HB
authors: El-Serag
authors: Program in Epidemiology, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
authors: Thomas L
authors: TL
authors: Vaughan
authors: Kaiser Permanente Division of Research, Oakland, California and San Francisco Medical Center, USA.
authors: Jennifer L
authors: JL
authors: Schneider
authors: QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.
authors: David C
authors: DC
authors: Whiteman
authors: Kaiser Permanente Division of Research, Oakland, California and San Francisco Medical Center, USA.
authors: Douglas A
authors: DA
authors: Corley
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001241:Aspirin / Q000627:therapeutic use*; D001471:Barrett Esophagus / Q000453:epidemiology*; D016022:Case-Control Studies; D004938:Esophageal Neoplasms / Q000453:epidemiology; D005260:Female; D005764:Gastroesophageal Reflux / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D065840:Protective Factors
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin