• Gastroesophageal reflux disease (GERD) is very common in the United States, affecting up to 27.8% of the population.
• Studies have suggested a possible link between GERD and cancers of the larynx and esophagus.
• A recent study adds further evidence to these findings.

In a new study, researchers found evidence of a link between GERD and cancers of the larynx and esophagus. The study, which appears in the journal Cancer, adds to an existing body of evidence.

The researchers hope that, if their results are confirmed, they might “inform clinical surveillance of GERD patients and suggest new avenues for prevention of these malignancies.”

Symptoms of GERD

GERD is a type of chronic gastrointestinal disease that causes the contents of the stomach to rise into the esophagus.

Researchers estimate that GERD affects 18.1% to 27.8% of people in the U.S.

People with GERD may experience heartburn or regurgitation, as well as chest pains, nausea, trouble swallowing, or a persistent cough.

GERD occurs when a person’s lower esophageal sphincter weakens or relaxes at the wrong times. Having overweight or obesity, being pregnant, and smoking are each risk factors for GERD.

Researchers have linked GERD to laryngeal squamous cell carcinoma (LSCC), a type of cancer of the aerodigestive tract. This part of the body includes the organs and tissues of the respiratory tract and upper digestive tract.

The authors of the present study note that earlier findings have been inconsistent.

They explain that “Most previous studies have been limited by size, study design, or insufficient control for important potential confounders, [such as] tobacco use and alcohol consumption, limiting the strength of the inference.”

In addition, no studies had investigated the possible link between GERD and esophageal squamous cell carcinoma (ESCC), another aerodigestive tract cancer.

Extracting the data

To address this, the researchers conducted a prospective study, drawing on data from the NIH‐AARP Diet and Health Study, which began in 1990s, with questionnaires sent to members of the American Association of Retired Persons, or AARP.

The participants were aged 50–71 years and located throughout the U.S. The researchers made use of the responses from 490,605 participants, 92.6% of whom identified as non-Hispanic white.

The questionnaire asked about various risk factors related to GERD, such as alcohol consumption, tobacco use, diet, body shape, and medical issues.

The researchers then cross-checked this data with data from Medicare claims related to GERD and also estimated the presence of GERD for those not eligible for Medicare. Overall, the team estimated that 23.7% of the sample they analyzed had a history of GERD.

They then used data from state cancer registries to determine whether the participants had developed LSCC, ESCC, or a type of cancer called esophageal adenocarcinoma (EADC) over the following 16 years.

GERD and cancer

The researchers found that participants with GERD were twice as likely as those without it to develop LSCC, ESCC, or EADC in the 16 years after they had filled out the questionnaire.

This relationship was present even after taking into account potentially confounding factors, such as tobacco use and alcohol consumption.

Across the U.S., the researchers estimate that “16.92% of LSCC cases and 17.32% of ESCC cases among individuals aged 50–71 years” are associated with GERD.

However, as the scientists note, their study has some limitations. For example, they estimated the presence of GERD based on medical claims, which may not account for people who treat their GERD with over-the-counter medicine.

Also, the reliance on Medicare data meant that a significant number of participants had no record of GERD, so the researchers needed to extrapolate from the data available.

Dr. Christian C. Abnet, a senior investigator at the National Cancer Institute and the corresponding author of the study, acknowledges, “This study alone is not sufficient to result in specific actions by the public. Additional research is needed to replicate these findings and establish GERD as a risk factor for cancer and other diseases.”

“Future studies are needed to evaluate whether treatments aimed at GERD symptoms will alter the apparent risks.”

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