In the Journals

NSAIDs not linked to lower risk for Barrett's esophagus

While prior studies have linked regular use of non-steroidal anti-inflammatory drugs with a reduced risk for esophageal cancer, a recent study found NSAID use was not associated with a reduced risk for developing the cancer precursor Barrett’s esophagus.

This finding led researchers to conclude that the chemoprotective effects of NSAIDs might only occur after the development of Barrett’s esophagus.

Aaron P. Thrift, PhD

Aaron P. Thrift

“Several epidemiological studies have shown that use of aspirin and other [NSAIDs] may reduce the risk of developing esophageal adenocarcinoma,” Aaron P. Thrift, PhD, from the department of medicine, section of gastroenterology and hepatology, and the Dan L. Duncan Comprehensive Cancer Center at Baylor College of Medicine in Houston, Texas, told Healio Gastroenterology. “However, a question of considerable clinical importance is whether NSAIDs affect risk of esophageal adenocarcinoma by preventing the development of the precursor lesion, Barrett’s esophagus, by preventing progression from Barrett’s to cancer, or both.”

Therefore, Thrift and colleagues evaluated data from six case-control studies within the Barrett’s and Esophageal Adenocarcinoma Consortium (BEACON), comparing medication use among 1,474 patients with Barrett’s esophagus, 2,256 population-based controls and 2,018 controls with GERD. Overall, 31.7% of the study population used aspirin at least once per week, 19.6% used non-aspirin NSAIDs at least once per week, and 47% used any NSAIDs at least once per week.

Researchers used multivariable logistic regression models to estimate study-specific odds ratios, and used a random-effects meta-analytic model to combine them.

Ultimately, they found the risk for Barrett’s esophagus was not associated with NSAIDs when used at least once a week, at least daily, or for at least 5 years. There was also no association among patients who took aspirin or non-aspirin NSAIDs.

“The results of our large pooled analysis show that NSAID use is not associated with risk of Barrett’s esophagus. This therefore suggests that any protective effect of NSAIDs is likely through preventing the development of esophageal adenocarcinoma in patients with Barrett’s esophagus,” Thrift said. “These findings are probably actually good for the prospects of NSAIDs as chemopreventive tools against esophageal adenocarcinoma as you have the prospect of treating a much smaller group of patients at much higher risk to achieve chemoprevention.” – by Adam Leitenberger

Disclosures: The researchers report no relevant financial disclosures.

While prior studies have linked regular use of non-steroidal anti-inflammatory drugs with a reduced risk for esophageal cancer, a recent study found NSAID use was not associated with a reduced risk for developing the cancer precursor Barrett’s esophagus.

This finding led researchers to conclude that the chemoprotective effects of NSAIDs might only occur after the development of Barrett’s esophagus.

Aaron P. Thrift, PhD

Aaron P. Thrift

“Several epidemiological studies have shown that use of aspirin and other [NSAIDs] may reduce the risk of developing esophageal adenocarcinoma,” Aaron P. Thrift, PhD, from the department of medicine, section of gastroenterology and hepatology, and the Dan L. Duncan Comprehensive Cancer Center at Baylor College of Medicine in Houston, Texas, told Healio Gastroenterology. “However, a question of considerable clinical importance is whether NSAIDs affect risk of esophageal adenocarcinoma by preventing the development of the precursor lesion, Barrett’s esophagus, by preventing progression from Barrett’s to cancer, or both.”

Therefore, Thrift and colleagues evaluated data from six case-control studies within the Barrett’s and Esophageal Adenocarcinoma Consortium (BEACON), comparing medication use among 1,474 patients with Barrett’s esophagus, 2,256 population-based controls and 2,018 controls with GERD. Overall, 31.7% of the study population used aspirin at least once per week, 19.6% used non-aspirin NSAIDs at least once per week, and 47% used any NSAIDs at least once per week.

Researchers used multivariable logistic regression models to estimate study-specific odds ratios, and used a random-effects meta-analytic model to combine them.

Ultimately, they found the risk for Barrett’s esophagus was not associated with NSAIDs when used at least once a week, at least daily, or for at least 5 years. There was also no association among patients who took aspirin or non-aspirin NSAIDs.

“The results of our large pooled analysis show that NSAID use is not associated with risk of Barrett’s esophagus. This therefore suggests that any protective effect of NSAIDs is likely through preventing the development of esophageal adenocarcinoma in patients with Barrett’s esophagus,” Thrift said. “These findings are probably actually good for the prospects of NSAIDs as chemopreventive tools against esophageal adenocarcinoma as you have the prospect of treating a much smaller group of patients at much higher risk to achieve chemoprevention.” – by Adam Leitenberger

Disclosures: The researchers report no relevant financial disclosures.