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Antacid drug use and risk of esophageal and gastric adenocarcinomas in Los Angeles County.
Cancer Epidemiol Biomarkers Prev. 2009 Feb; 18(2):526-33.CE

Abstract

OBJECTIVES

Concern has been expressed that antacid drugs increase the risk of esophageal and gastric adenocarcinomas.

METHODS

This population-based case-control study recruited patients with incident esophageal adenocarcinoma (n = 220), gastric cardiac adenocarcinoma (n = 277), or distal gastric adenocarcinoma (n = 441) diagnosed between 1992 and 1997, and 1,356 control participants in Los Angeles County. Unconditional polychotomous multivariable logistic regression analyses were done to evaluate the association between antacid drug use and these cancers.

RESULTS

Among participants who took nonprescription acid neutralizing agents for >3 years, the odds ratio for esophageal adenocarcinoma was 6.32 compared with never users (95% confidence interval, 3.14-12.69; P(trend) < 0.01). Analyses stratified by history of physician diagnosed upper gastrointestinal (UGI) disorders revealed a greater increase in esophageal adenocarcinoma risk associated with nonprescription antacid use among persons with no UGI disorder than among those with an UGI disorder (homogeneity of trends P = 0.07). Regular use of nonprescription acid neutralizing agents was not associated with risk of adenocarcinomas of the gastric cardia or distal stomach. Regular use of prescription acid suppressive drugs was not associated with risk for any of these cancers.

CONCLUSION

We found risk of esophageal adenocarcinoma was greater among long-term nonprescription acid neutralizing drugs in participants without physician-diagnosed UGI conditions than among those with these conditions; this may represent self medication for undiagnosed precursor conditions or it may be that nonprescription acid neutralizing drugs, taken without limitation on amount used when symptoms are most intense, may permit alkaline bile reflux into the lower esophagus, thereby increasing esophageal adenocarcinoma risk.

Authors+Show Affiliations

Division of Cancer Etiology, Department of Population Sciences, City of Hope National Medical Center, Duarte, CA 91010, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19190141

Citation

Duan, Lei, et al. "Antacid Drug Use and Risk of Esophageal and Gastric Adenocarcinomas in Los Angeles County." Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, vol. 18, no. 2, 2009, pp. 526-33.
Duan L, Wu AH, Sullivan-Halley J, et al. Antacid drug use and risk of esophageal and gastric adenocarcinomas in Los Angeles County. Cancer Epidemiol Biomarkers Prev. 2009;18(2):526-33.
Duan, L., Wu, A. H., Sullivan-Halley, J., & Bernstein, L. (2009). Antacid drug use and risk of esophageal and gastric adenocarcinomas in Los Angeles County. Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, 18(2), 526-33. https://doi.org/10.1158/1055-9965.EPI-08-0764
Duan L, et al. Antacid Drug Use and Risk of Esophageal and Gastric Adenocarcinomas in Los Angeles County. Cancer Epidemiol Biomarkers Prev. 2009;18(2):526-33. PubMed PMID: 19190141.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antacid drug use and risk of esophageal and gastric adenocarcinomas in Los Angeles County. AU - Duan,Lei, AU - Wu,Anna H, AU - Sullivan-Halley,Jane, AU - Bernstein,Leslie, Y1 - 2009/02/03/ PY - 2009/2/5/entrez PY - 2009/2/5/pubmed PY - 2009/4/17/medline SP - 526 EP - 33 JF - Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology JO - Cancer Epidemiol. Biomarkers Prev. VL - 18 IS - 2 N2 - OBJECTIVES: Concern has been expressed that antacid drugs increase the risk of esophageal and gastric adenocarcinomas. METHODS: This population-based case-control study recruited patients with incident esophageal adenocarcinoma (n = 220), gastric cardiac adenocarcinoma (n = 277), or distal gastric adenocarcinoma (n = 441) diagnosed between 1992 and 1997, and 1,356 control participants in Los Angeles County. Unconditional polychotomous multivariable logistic regression analyses were done to evaluate the association between antacid drug use and these cancers. RESULTS: Among participants who took nonprescription acid neutralizing agents for >3 years, the odds ratio for esophageal adenocarcinoma was 6.32 compared with never users (95% confidence interval, 3.14-12.69; P(trend) < 0.01). Analyses stratified by history of physician diagnosed upper gastrointestinal (UGI) disorders revealed a greater increase in esophageal adenocarcinoma risk associated with nonprescription antacid use among persons with no UGI disorder than among those with an UGI disorder (homogeneity of trends P = 0.07). Regular use of nonprescription acid neutralizing agents was not associated with risk of adenocarcinomas of the gastric cardia or distal stomach. Regular use of prescription acid suppressive drugs was not associated with risk for any of these cancers. CONCLUSION: We found risk of esophageal adenocarcinoma was greater among long-term nonprescription acid neutralizing drugs in participants without physician-diagnosed UGI conditions than among those with these conditions; this may represent self medication for undiagnosed precursor conditions or it may be that nonprescription acid neutralizing drugs, taken without limitation on amount used when symptoms are most intense, may permit alkaline bile reflux into the lower esophagus, thereby increasing esophageal adenocarcinoma risk. SN - 1055-9965 UR - https://www.unboundmedicine.com/medline/citation/19190141/Antacid_drug_use_and_risk_of_esophageal_and_gastric_adenocarcinomas_in_Los_Angeles_County_ L2 - http://cebp.aacrjournals.org/cgi/pmidlookup?view=long&amp;pmid=19190141 DB - PRIME DP - Unbound Medicine ER -