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Incidence and Mortality in Upper Gastrointestinal Cancer After Negative Endoscopy for Gastroesophageal Reflux Disease

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Incidence and Mortality in Upper Gastrointestinal Cancer After Negative Endoscopy for Gastroesophageal Reflux Disease. / Holmberg, Dag; Santoni, Giola; von Euler-Chelpin, My Catarina et al.

In: Gastroenterology, Vol. 162, No. 2, 02.2022, p. 431-438.e4.

Research output: Contribution to journalArticlepeer-review

Harvard

Holmberg, D, Santoni, G, von Euler-Chelpin, MC, Färkkilä, M, Kauppila, JH, Maret-Ouda, J, Ness-Jensen, E & Lagergren, J 2022, 'Incidence and Mortality in Upper Gastrointestinal Cancer After Negative Endoscopy for Gastroesophageal Reflux Disease', Gastroenterology, vol. 162, no. 2, pp. 431-438.e4. https://doi.org/10.1053/j.gastro.2021.10.003

APA

Holmberg, D., Santoni, G., von Euler-Chelpin, M. C., Färkkilä, M., Kauppila, J. H., Maret-Ouda, J., Ness-Jensen, E., & Lagergren, J. (2022). Incidence and Mortality in Upper Gastrointestinal Cancer After Negative Endoscopy for Gastroesophageal Reflux Disease. Gastroenterology, 162(2), 431-438.e4. https://doi.org/10.1053/j.gastro.2021.10.003

Vancouver

Holmberg D, Santoni G, von Euler-Chelpin MC, Färkkilä M, Kauppila JH, Maret-Ouda J et al. Incidence and Mortality in Upper Gastrointestinal Cancer After Negative Endoscopy for Gastroesophageal Reflux Disease. Gastroenterology. 2022 Feb;162(2):431-438.e4. https://doi.org/10.1053/j.gastro.2021.10.003

Author

Holmberg, Dag ; Santoni, Giola ; von Euler-Chelpin, My Catarina et al. / Incidence and Mortality in Upper Gastrointestinal Cancer After Negative Endoscopy for Gastroesophageal Reflux Disease. In: Gastroenterology. 2022 ; Vol. 162, No. 2. pp. 431-438.e4.

Bibtex Download

@article{3e4a3d5c4026439182265d55f8daafb0,
title = "Incidence and Mortality in Upper Gastrointestinal Cancer After Negative Endoscopy for Gastroesophageal Reflux Disease",
abstract = "Background and Aims: Gastroesophageal reflux disease (GERD) is associated with an increased risk of cancer of the upper gastrointestinal tract. This study aimed to assess whether and to what extent a negative upper endoscopy in patients with GERD is associated with decreased incidence and mortality in upper gastrointestinal cancer (ie, esophageal, gastric, or duodenal cancer). Methods: We conducted a population-based cohort study of all patients with newly diagnosed GERD between July 1, 1979 and December 31, 2018 in Denmark, Finland, Norway, and Sweden. The exposure, negative upper endoscopy, was examined as a time-varying exposure, where participants contributed unexposed person-time from GERD diagnosis until screened and exposed person-time from the negative upper endoscopy. The incidence and mortality in upper gastrointestinal cancer were assessed using parametric flexible models, providing adjusted hazard ratios (HRs) with 95% confidence intervals (CIs). Results: Among 1,062,740 patients with GERD (median age 58 years; 52% were women) followed for a mean of 7.0 person-years, 5324 (0.5%) developed upper gastrointestinal cancer and 4465 (0.4%) died from such cancer. Patients who had a negative upper endoscopy had a 55% decreased risk of upper gastrointestinal cancer compared with those who did not undergo endoscopy (HR, 0.45; 95% CI, 0.43–0.48), a decrease that was more pronounced during more recent years (HR, 0.34; 95% CI, 0.30–0.38 from 2008 onward), and was otherwise stable across sex and age groups. The corresponding reduction in upper gastrointestinal mortality among patients with upper endoscopy was 61% (adjusted HR, 0.39; 95% CI, 0.37–0.42). The risk reduction after a negative upper endoscopy in incidence and mortality lasted for 5 and at least 10 years, respectively. Conclusions: Negative upper endoscopy is associated with strong and long-lasting decreases in incidence and mortality in upper gastrointestinal cancer in patients with GERD.",
keywords = "Esophageal Neoplasm, Gastric Neoplasm, Gastroesophageal Reflux Disease, Gastroscopy",
author = "Dag Holmberg and Giola Santoni and {von Euler-Chelpin}, {My Catarina} and Martti F{\"a}rkkil{\"a} and Kauppila, {Joonas H.} and John Maret-Ouda and Eivind Ness-Jensen and Jesper Lagergren",
note = "Funding Information: Funding Supported by the Swedish Research Council (2019-00209) and Swedish Cancer Society (180684). Publisher Copyright: {\textcopyright} 2022 The Authors",
year = "2022",
month = feb,
doi = "10.1053/j.gastro.2021.10.003",
language = "English",
volume = "162",
pages = "431--438.e4",
journal = "Gastroenterology",
issn = "0016-5085",
publisher = "WB Saunders",
number = "2",

}

RIS (suitable for import to EndNote) Download

TY - JOUR

T1 - Incidence and Mortality in Upper Gastrointestinal Cancer After Negative Endoscopy for Gastroesophageal Reflux Disease

AU - Holmberg, Dag

AU - Santoni, Giola

AU - von Euler-Chelpin, My Catarina

AU - Färkkilä, Martti

AU - Kauppila, Joonas H.

AU - Maret-Ouda, John

AU - Ness-Jensen, Eivind

AU - Lagergren, Jesper

N1 - Funding Information: Funding Supported by the Swedish Research Council (2019-00209) and Swedish Cancer Society (180684). Publisher Copyright: © 2022 The Authors

PY - 2022/2

Y1 - 2022/2

N2 - Background and Aims: Gastroesophageal reflux disease (GERD) is associated with an increased risk of cancer of the upper gastrointestinal tract. This study aimed to assess whether and to what extent a negative upper endoscopy in patients with GERD is associated with decreased incidence and mortality in upper gastrointestinal cancer (ie, esophageal, gastric, or duodenal cancer). Methods: We conducted a population-based cohort study of all patients with newly diagnosed GERD between July 1, 1979 and December 31, 2018 in Denmark, Finland, Norway, and Sweden. The exposure, negative upper endoscopy, was examined as a time-varying exposure, where participants contributed unexposed person-time from GERD diagnosis until screened and exposed person-time from the negative upper endoscopy. The incidence and mortality in upper gastrointestinal cancer were assessed using parametric flexible models, providing adjusted hazard ratios (HRs) with 95% confidence intervals (CIs). Results: Among 1,062,740 patients with GERD (median age 58 years; 52% were women) followed for a mean of 7.0 person-years, 5324 (0.5%) developed upper gastrointestinal cancer and 4465 (0.4%) died from such cancer. Patients who had a negative upper endoscopy had a 55% decreased risk of upper gastrointestinal cancer compared with those who did not undergo endoscopy (HR, 0.45; 95% CI, 0.43–0.48), a decrease that was more pronounced during more recent years (HR, 0.34; 95% CI, 0.30–0.38 from 2008 onward), and was otherwise stable across sex and age groups. The corresponding reduction in upper gastrointestinal mortality among patients with upper endoscopy was 61% (adjusted HR, 0.39; 95% CI, 0.37–0.42). The risk reduction after a negative upper endoscopy in incidence and mortality lasted for 5 and at least 10 years, respectively. Conclusions: Negative upper endoscopy is associated with strong and long-lasting decreases in incidence and mortality in upper gastrointestinal cancer in patients with GERD.

AB - Background and Aims: Gastroesophageal reflux disease (GERD) is associated with an increased risk of cancer of the upper gastrointestinal tract. This study aimed to assess whether and to what extent a negative upper endoscopy in patients with GERD is associated with decreased incidence and mortality in upper gastrointestinal cancer (ie, esophageal, gastric, or duodenal cancer). Methods: We conducted a population-based cohort study of all patients with newly diagnosed GERD between July 1, 1979 and December 31, 2018 in Denmark, Finland, Norway, and Sweden. The exposure, negative upper endoscopy, was examined as a time-varying exposure, where participants contributed unexposed person-time from GERD diagnosis until screened and exposed person-time from the negative upper endoscopy. The incidence and mortality in upper gastrointestinal cancer were assessed using parametric flexible models, providing adjusted hazard ratios (HRs) with 95% confidence intervals (CIs). Results: Among 1,062,740 patients with GERD (median age 58 years; 52% were women) followed for a mean of 7.0 person-years, 5324 (0.5%) developed upper gastrointestinal cancer and 4465 (0.4%) died from such cancer. Patients who had a negative upper endoscopy had a 55% decreased risk of upper gastrointestinal cancer compared with those who did not undergo endoscopy (HR, 0.45; 95% CI, 0.43–0.48), a decrease that was more pronounced during more recent years (HR, 0.34; 95% CI, 0.30–0.38 from 2008 onward), and was otherwise stable across sex and age groups. The corresponding reduction in upper gastrointestinal mortality among patients with upper endoscopy was 61% (adjusted HR, 0.39; 95% CI, 0.37–0.42). The risk reduction after a negative upper endoscopy in incidence and mortality lasted for 5 and at least 10 years, respectively. Conclusions: Negative upper endoscopy is associated with strong and long-lasting decreases in incidence and mortality in upper gastrointestinal cancer in patients with GERD.

KW - Esophageal Neoplasm

KW - Gastric Neoplasm

KW - Gastroesophageal Reflux Disease

KW - Gastroscopy

UR - http://www.scopus.com/inward/record.url?scp=85121691095&partnerID=8YFLogxK

U2 - 10.1053/j.gastro.2021.10.003

DO - 10.1053/j.gastro.2021.10.003

M3 - Article

C2 - 34627859

AN - SCOPUS:85121691095

VL - 162

SP - 431-438.e4

JO - Gastroenterology

JF - Gastroenterology

SN - 0016-5085

IS - 2

ER -

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