MedWire News: Antireflux surgery does not prevent development of esophageal or cardia adenocarcinoma in patients with reflux, show study results.
“The incidence rates of adenocarcinoma of the esophagus and the gastroesophageal junction (cardia) have been increasing rapidly in Western populations during the past few decades,” say researchers.
They add: “Despite attempts to improve the detection and treatment of these highly lethal cancers, the overall chance of 5-year survival remains only 10%–15%.”
To investigate the suggestion that antireflux surgery may have a preventive effect on these cancers in people with reflux, which is a known risk factor, Jesper Lagergren (Karolinska Institutet, Stockholm, Sweden) and colleagues carried out a population based cohort study of 14,102 people with gastroesophageal reflux disease (GERD) who had antireflux surgery from 1965 to 2006.
The cohort were followed-up for incidence of cancer, particularly esophageal or cardia adenocarcinoma, until December 2006 and the incidence rates were compared with those of the corresponding Swedish population.
Lagergren and team found that individuals with GERD had a 12-fold increased risk for esophageal carcinoma compared with the general Swedish population before surgery. Contrary to expectations, no decrease in risk was observed in these individuals after surgery.
In fact, when patients were followed up 15 years or more after surgery they had a 14.6-fold increased risk for esophageal carcinoma compared with the general Swedish population.
Overall risk for cardia adenocarcinoma was also higher for GERD patients than controls by 3.1–4.4-fold over the follow-up period.
“This large and population-based cohort study with long and complete follow-up evaluation indicates that antireflux surgery does not prevent the development of esophageal or cardia adenocarcinoma among persons with reflux,” conclude the authors in the journal Gastroenterology.
“Thus, antireflux surgery should not be considered a cancer-preventive therapy,” they say.
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010
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