Gastroesophageal reflux disease (GERD) is the most common reason for referral for upper endoscopy. This study sought to determine whether there is a relationship between a negative endoscopy and the incidence of and mortality from upper GI (UGI) malignancies. <\/p>\n\n\n\n
This population-based cohort study included more than 1.06 million participants (median age, 58; 48% male) with GERD, newly diagnosed from 1979 through 2018 in Nordic countries. Exposure was defined as negative endoscopy (no diagnosis of premalignant conditions or GI cancer within 6 months of endoscopy). <\/p>\n\n\n\n
During 3.04 million unexposed person-years of follow-up (time when no endoscopies were performed), 3601 people (0.34%) developed UGI cancer. Of 736,759 patients with a negative endoscopy (4.43 million exposed person-years), 1723 patients (0.23%) developed UGI cancer, and 1609 (0.22%) died due to their malignancy. The incidence of UGI cancer during unexposed person-time in patients with GERD was 119 per 100,000 person-years (95% confidence interval [CI], 115-123). The rate after a negative endoscopy was 38 per 100,000 person-years (95% CI, 37-40), and the adjusted hazard ratio (HR) was 0.45 (95% CI, 0.43-0.48), amounting to a 55% decreased risk of UGI cancers in patients with a negative upper endoscopy. This risk reduction was similar when stratified for esophageal cancer (52% reduction: HR, 0.48; 95% CI, 0.44-0.51) and gastric cancer (59% reduction: HR, 0.41; 95% CI, 0.38-0.45). The decreased risk was greatest after the first year of follow-up and lasted 5 years. <\/p>\n\n\n\n
Patients with GERD who had negative upper endoscopy had a 61% decreased risk of mortality from UGI cancer compared with those without an upper endoscopy (HR, 0.39; 95% CI, 0.37-0.42). Similarly, the adjusted HRs were greatest during the first year of follow-up, but overall risk was improved for 10 years. <\/p>\n\n\n\n
In a subgroup analysis, the risk of developing esophageal adenocarcinoma was cut in half (HR, 0.50; 95% CI, 0.45-0.55), and the risk of dying from the same was reduced by 67% (adjusted HR, 0.33; 95% CI, 0.30-0.37). Finally, there was a larger risk reduction noted after 2007 compared with the earlier group, which was thought to be due to the improvement in endoscopy technology during the study period.<\/p>\n","protected":false},"excerpt":{"rendered":"
Gastroesophageal reflux disease (GERD) is the most common reason for referral for upper endoscopy. This study sought to determine whether there is a relationship between a negative endoscopy and the incidence of and mortality from upper GI (UGI) malignancies. This population-based cohort study included more than 1.06 million participants (median age, 58; 48% male) with … Read more<\/a><\/p>\n","protected":false},"template":"","categories":[1768,1791],"tags":[2098,2572,2070,2467,1390],"class_list":["post-11240","ec-news","type-ec-news","status-publish","hentry","category-asge-journal-scan","category-esophagus","tag-esophagus-2","tag-gastroesophageal-reflux-disease","tag-gerd-2","tag-ugi","tag-upper-gi"],"_links":{"self":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/ec-news\/11240","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/ec-news"}],"about":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/types\/ec-news"}],"wp:attachment":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/media?parent=11240"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/categories?post=11240"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/tags?post=11240"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}