CANCER of the oesophagus could be prevented by treating severe heartburn medically or surgically, according to a study from the Karolinska Institutet, Solna, Sweden.
Prof Jesper Lagergren, Karolinska Institutet, who led the study, commented: “Previous research results have shown poor cancer-preventive effects from anti-reflux surgery. The difference now is that for the first time we can show statistically significant results because we have a sufficiently large study with a long-follow-up period of over 15 years following the operation.”
Reflux is strongly associated with a higher risk of developing oesophageal adenocarcinoma. To date, however, evidence of whether treating reflux can help reduce this risk is conflicting.
Usually, medication is used to eliminate or reduce symptoms in reflux patients by reducing acidity in their stomach contents. Anti-reflux surgery is an alternative form of therapy, which works by preventing the contents of the stomach from moving up into the oesophagus.
Decrease in Risk
In this new study, the researchers used population health data records between the years of 1964 and 2014 from the five Nordic countries to observe the effect of these treatments on the risk of developing cancer of the oesophagus. They found that of the roughly 895,000 patients with reflux who received medical treatment, 0.3% (2,370 patients) went on the develop the cancer during the follow-up period. The risk clearly decreased as time went by in this cohort, reaching similar levels to the rest of the population 15 years or more after their treatment.
In the over 48,400 reflux patients who had surgery to treat the condition, 0.4% (177 patients) developed the cancer during the follow-up period. Similarly to those receiving medication, the risk of developing the condition fell over time and was at the same level as the corresponding population 15 years or more after the operation took place.
The authors caution that reflux should not be routinely treated as a cancer-preventative measure in light of these findings. Dr John Maret-Ouda, Karolinska Institutet, said: “The results show that effective medical or surgical treatment of reflux prevents cancer of the oesophagus. But because the individual’s risk of developing oesophageal cancer is low, even in those with reflux disease, the results do not justify treating reflux solely as a cancer-preventive measure. The symptoms and complications of reflux disease should continue to govern treatment.”
They did, however, add that continuous medical treatment or an operation is recommended for the small proportion of individuals who have severe reflux in combination with other risk factors for oesophageal cancer, including obesity and mature age.
James Coker, Reporter
For the source and further information about the study, click here.