title: All-cause and cancer-specific mortality in GORD in a population-based cohort study (the HUNT study).
abstract: Gastro-oesophageal reflux is a public health concern which could have associated oesophageal complications, including adenocarcinoma, and possibly also head-and-neck and lung cancers. The aim of this study was to test the hypothesis that reflux increases all-cause and cancer-specific mortalities in an unselected cohort.
  
  
  
  The Nord-Trøndelag health study (HUNT), a Norwegian population-based cohort study, was used to identify individuals with and without reflux in 1995-1997 and 2006-2008, with follow-up until 2014. All-cause mortality and cancer-specific mortality were assessed from the Norwegian Cause of Death Registry and Cancer Registry. Multivariable Cox regression was used to calculate HRs with 95% CIs for mortality with adjustments for potential confounders.
  
  
  
  We included 4758 participants with severe reflux symptoms and 51 381 participants without reflux symptoms, contributing 60 323 and 747 239 person-years at risk, respectively. Severe reflux was not associated with all-cause mortality, overall cancer-specific mortality or mortality in cancer of the head-and-neck or lung. However, for men with severe reflux a sixfold increase in oesophageal adenocarcinoma-specific mortality was found (HR 6.09, 95% CI 2.33 to 15.93) and the mortality rate was 0.27 per 1000 person-years. For women, the corresponding mortality was not significantly increased (HR 3.68, 95% CI 0.88 to 15.27) and the mortality rate was 0.05 per 1000 person-years.
  
  
  
  Individuals with severe reflux symptoms do not seem to have increased all-cause mortality or overall cancer-specific mortality. Although the absolute risk is small, individuals with severe reflux symptoms have a clearly increased oesophageal adenocarcinoma-specific mortality.
authors: Upper Gastrointestinal Surgery, Department of Molecular medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.|HUNT Research Centre, Department of Public Health and General Practice, NTNU, Norwegian University of Science and Technology, Levanger, Norway.|Medical Department, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway.
authors: Eivind
authors: E
authors: Ness-Jensen
authors: Upper Gastrointestinal Surgery, Department of Molecular medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
authors: Eivind
authors: E
authors: Gottlieb-Vedi
authors: Upper Gastrointestinal Surgery, Department of Molecular medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
authors: Karl
authors: K
authors: Wahlin
authors: Upper Gastrointestinal Surgery, Department of Molecular medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.|Division of Cancer Studies, King's College London, London, UK.
authors: Jesper
authors: J
authors: Lagergren
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D004938:Esophageal Neoplasms / Q000401:mortality*; D005260:Female; D005764:Gastroesophageal Reflux / Q000453:epidemiology / Q000401:mortality*; D006258:Head and Neck Neoplasms / Q000401:mortality; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D012720:Severity of Illness Index; D012737:Sex Factors; D055815:Young Adult
keywords: ACID-RELATED DISEASES; ADENOCARCINOMA; CANCER; EPIDEMIOLOGY; GASTROESOPHAGEAL REFLUX DISEASE