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NSAIDs, statins, low-dose aspirin and PPIs, and the risk of oesophageal adenocarcinoma among patients with Barrett's oesophagus: a population-based case-control study.

Masclee GM, Coloma PM, Spaander MC, Kuipers EJ, Sturkenboom MC - BMJ Open (2015)

Bottom Line: Low-dose aspirin and PPIs did not significantly decrease the risk of OAC and HGD.In this population-based nested case-control study, use of NSAIDs, PPIs, low-dose aspirin or statins did not reduce the risk of HGD and OAC among patients with BO.These findings indicate that for an unselected group of patients with BO chemoprevention by use of drugs to reduce progression to HGD and OAC should not be directly considered as routine care.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, The Netherlands Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands.

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Flowchart of Barrett's oesophagus and oesophageal adenocarcinoma cases in the UK and the Netherlands. BO, Barrett's oesophagus; OAC, oesophageal adenocarcinoma; HGD, high-grade dysplasia; THIN, The Health Improvement Network; IPCI, Integrated Primary Care Information; PYs, person years.
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BMJOPEN2014006640F1: Flowchart of Barrett's oesophagus and oesophageal adenocarcinoma cases in the UK and the Netherlands. BO, Barrett's oesophagus; OAC, oesophageal adenocarcinoma; HGD, high-grade dysplasia; THIN, The Health Improvement Network; IPCI, Integrated Primary Care Information; PYs, person years.

Mentions: In the UK, we identified 40 incident OAC cases within the BO cohort (0.3%) to whom we could match 656 controls. Median number of controls per case was 17 (IQR 9–23). In NL we identified five incident OAC cases among the BO cohort (0.3%). These were matched to 76 control subjects, with a median of 5 controls per case (IQR 4–6). In addition, we identified 12 HGD cases, resulting in a second case–control set of 17 cases (5 OAC+12 HGD) matched to 753 controls (median 44 controls; IQR 6–61). Figure 1 shows a flowchart of the study population. Table 1 provides baseline characteristics of cases and controls. In the UK, a larger proportion of cases had a body mass index (BMI) over 25 kg/m2; 68% of cases and 59% of controls. In NL, the BMI of only one case within 1 year of OAC diagnosis was available (21.3 kg/m2). Controls had a mean BMI of 28.7 kg/m2 (SD 4.7) in NL. Presence of oesophagitis or gastritis at time of BO diagnosis was more often seen in controls than in cases. In the UK, a hiatal hernia was more often present among cases, whereas the opposite was found in NL. In the UK, OAC cases were more likely to be current smokers than controls (OR 3.3; 95% CI 1.4 to 8.0), as seen in NL, though not significantly. Mean time from BO diagnosis until OAC diagnosis was 4.2 (SD 2.5) years in the UK and 3.5 (SD 0.8) years in NL.


NSAIDs, statins, low-dose aspirin and PPIs, and the risk of oesophageal adenocarcinoma among patients with Barrett's oesophagus: a population-based case-control study.

Masclee GM, Coloma PM, Spaander MC, Kuipers EJ, Sturkenboom MC - BMJ Open (2015)

Flowchart of Barrett's oesophagus and oesophageal adenocarcinoma cases in the UK and the Netherlands. BO, Barrett's oesophagus; OAC, oesophageal adenocarcinoma; HGD, high-grade dysplasia; THIN, The Health Improvement Network; IPCI, Integrated Primary Care Information; PYs, person years.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4316430&req=5

BMJOPEN2014006640F1: Flowchart of Barrett's oesophagus and oesophageal adenocarcinoma cases in the UK and the Netherlands. BO, Barrett's oesophagus; OAC, oesophageal adenocarcinoma; HGD, high-grade dysplasia; THIN, The Health Improvement Network; IPCI, Integrated Primary Care Information; PYs, person years.
Mentions: In the UK, we identified 40 incident OAC cases within the BO cohort (0.3%) to whom we could match 656 controls. Median number of controls per case was 17 (IQR 9–23). In NL we identified five incident OAC cases among the BO cohort (0.3%). These were matched to 76 control subjects, with a median of 5 controls per case (IQR 4–6). In addition, we identified 12 HGD cases, resulting in a second case–control set of 17 cases (5 OAC+12 HGD) matched to 753 controls (median 44 controls; IQR 6–61). Figure 1 shows a flowchart of the study population. Table 1 provides baseline characteristics of cases and controls. In the UK, a larger proportion of cases had a body mass index (BMI) over 25 kg/m2; 68% of cases and 59% of controls. In NL, the BMI of only one case within 1 year of OAC diagnosis was available (21.3 kg/m2). Controls had a mean BMI of 28.7 kg/m2 (SD 4.7) in NL. Presence of oesophagitis or gastritis at time of BO diagnosis was more often seen in controls than in cases. In the UK, a hiatal hernia was more often present among cases, whereas the opposite was found in NL. In the UK, OAC cases were more likely to be current smokers than controls (OR 3.3; 95% CI 1.4 to 8.0), as seen in NL, though not significantly. Mean time from BO diagnosis until OAC diagnosis was 4.2 (SD 2.5) years in the UK and 3.5 (SD 0.8) years in NL.

Bottom Line: Low-dose aspirin and PPIs did not significantly decrease the risk of OAC and HGD.In this population-based nested case-control study, use of NSAIDs, PPIs, low-dose aspirin or statins did not reduce the risk of HGD and OAC among patients with BO.These findings indicate that for an unselected group of patients with BO chemoprevention by use of drugs to reduce progression to HGD and OAC should not be directly considered as routine care.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, The Netherlands Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands.

Show MeSH
Related in: MedlinePlus