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British Medical JournalNon-erosive Gastroesophageal Reflux Disease and Incidence of Esophageal Adenocarcinoma in Three Nordic Countries: Population-based Cohort Study

When compared to the general population, did patients with non-erosive gastroesophageal reflux disease appear to have a similar incidence of esophageal adenocarcinoma?

A population-based cohort study evaluates the risk of developing esophageal adenocarcinoma among patients with non-erosive gastroesophageal reflux disease (GERD), and finds it equivalent to the general population, potentially influencing monitoring practices.

HCN Medical Memo
This study offers pivotal insights that may reshape how you approach the long-term endoscopic monitoring of non-erosive GERD patients. The data suggests that additional endoscopic surveillance for esophageal adenocarcinoma may not be warranted in these patients, aligning their monitoring protocol closer to that of the general population.

Study Design
  • Setting: Patients from hospitals and specialized outpatient healthcare in Denmark, Finland, and Sweden, spanning from January 1, 1987, to December 31, 2019.
  • Participants: 486,556 adults who had undergone endoscopy were considered, of which 285,811 were classified under non-erosive GERD and 200,745 under erosive GERD for validation.
  • Exposures: Non-erosive GERD was defined by the absence of esophagitis or any other esophageal diagnosis at endoscopy.
  • Main Outcome Measures: Incidence rate of esophageal adenocarcinoma was monitored for up to 31 years.

The incidence rate of oesophageal adenocarcinoma in patients with erosive GERD is nearly triple that of non-erosive GERD patients at 31.0/100,000 person-years.

Key Findings
  • 228 out of 285,811 non-erosive GERD patients developed esophageal adenocarcinomas during 2,081,051 person-years of follow-up.
  • Incidence rate in non-erosive GERD patients was 11.0/100,000 person-years, similar to the general population (Standardized Incidence Ratio 1.04; 95% CI, 0.91 to 1.18).
  • No increase in incidence was noted with longer follow-up.

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