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MONDAY, February 22, 2021 (HealthDay News) – People with chronic heartburn may face increased risks of several rare types of cancer, according to a large U.S. government study.
Researchers found that among more than 490,000 Americans aged 50 and over, those with gastroesophageal reflux disease (GERD) were about twice as likely to develop cancers of the esophagus or larynx (also known under the mailbox name).
GERD, or acid reflux, occurs when stomach acids chronically leak into the esophagus, which is the muscle tube connecting the throat and stomach. The most common symptom is heartburn.
The condition is extremely common, affecting about 20% of Americans, according to the United States National Institutes of Health (NIH).
GERD has long been established as a risk factor for esophageal adenocarcinoma, which in the United States is the most common type of tumor occurring in the esophagus.
The new study, published on February 22 in the journal Cancer, links GERD to a second type of cancer of the esophagus – called squamous cell carcinoma – as well as cancer of the larynx, which occurs in the voice box.
Experts have pointed out that the absolute risk is low: the vast majority of people with GERD will never develop cancers, which are all quite rare.
“Our results should not alarm people diagnosed with GERD,” said Christian Abnet, a researcher at the US National Cancer Institute who led the study.
However, worldwide, squamous cell carcinoma is actually the most common form of esophageal cancer, he noted, which is one of the reasons why it is important to study any link. with GERD.
Why is heartburn important in cancer?
The esophagus is not used to the “caustics” residing in the stomach and small intestine, including acids and digestive enzymes, Abnet explained.
The long-held theory around adenocarcinoma is that chronic exposure to these substances can damage esophageal tissue in a way that sometimes leads to cancer.
In fact, according to the NIH, about 10% to 15% of patients with GERD have reflux severe enough to cause abnormalities in the esophageal lining called Barrett’s esophagus. And among people with Barrett’s disease, the risk of developing esophageal adenocarcinoma is about 0.5% per year.
It is possible, Abnet said, that similar mechanisms could also contribute to squamous cell carcinoma of the esophagus and cancer of the larynx.
Whether treating GERD reduces these cancer risks “remains an open question,” he said.
In the United States, he noted, the main drivers of cancers studied here are smoking and binge drinking.
“So avoiding these exposures is the most important preventative measure,” Abnet said.
The results are based on more than 490,600 American adults aged 50 to 71 at baseline. Almost a quarter had GERD.
In about 16 years, more than 900 participants were diagnosed with adenocarcinoma of the esophagus, while about 300 developed the squamous cell form. During that time, 876 people were diagnosed with laryngeal cancer.
On average, the Abnet team found that people with GERD were about twice as likely to develop any of the three cancers as people without GERD. This was after taking into account smoking, drinking patterns and body weight.
Peter Campbell, scientific director of epidemiological research at the American Cancer Society, called the study “solid.”
There are no standard screening tests for cancers. But Campbell said people with GERD may be aware of potential symptoms, including: difficulty swallowing, chest pain, hoarseness or voice changes, chronic cough, and weight loss.
“It’s important to note that having these signs or symptoms doesn’t necessarily mean a person has cancer at any of these organ sites,” Campbell said.
But, he says, anyone with GERD who notices these symptoms should talk to their doctor.
Likewise, Abnet said people with symptoms of GERD should ask their doctors about lifestyle changes and / or medications that might help.
Lifestyle tactics for managing GERD include eating a healthy diet, quitting smoking and limiting alcohol, and losing weight.
As it happens, Abnet noted, these same measures can help reduce the risk of many types of cancer.
More information
The US National Institute of Diabetes and Digestive and Kidney Diseases has an overview of GERD.
SOURCES: Christian Abnet, PhD, MPH, Division of Cancer Epidemiology and Genetics, US National Cancer Institute, Rockville, Md .; Peter Campbell, PhD, Scientific Director, Epidemiological Research, American Cancer Society, Atlanta; Cancer, Feb. 22, 2021, online
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