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Heartburn treatment can help prevent Esophageal cancer

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10-20 percent of the adult population suffers from pathological heartburn and acid reflux. Long and severe reflux is the leading cause of esophageal cancer (type adenocarcinoma), an aggressive and difficult-to-treat disease.

Reflux is often treated with medication to decrease the acidity of the stomach contents, which generally removes or lessens symptoms. One option is to undergo an anti-reflux surgical procedure, which stops stomach contents from entering the esophagus.

Previous research hasn’t definitively shown that these therapies prevent esophageal cancer, but the trials were either too small or didn’t have enough follow-up time to make any conclusions on long-term cancer prevention effects.

In this study, researchers analyzed health data records from the five Nordic nations from 1964 to 2014 for their investigation. About 895,000 of the more than 940,000 reflux patients in the research got medical therapy, and approximately 2,370 of them (0.3%) developed esophageal cancer during the follow-up period.

Following therapy, the risk of esophageal cancer reduced over time and was comparable to that of the general population after 15 years or more among those who took medication.

During the follow-up period, 177 (0.4%) of the more than 48,400 patients who underwent anti-reflux surgery got esophageal cancer. This group’s risk of esophageal cancer also decreased, and 15 years or more after the surgery, it was at the same level as the general population.

When the patients with reflux who had an operation were compared with those with reflux who received medication, the patients who had been operated on had a slightly higher risk of esophageal cancer during the entire follow-up period, but the risk did not increase over time. This is probably caused by the fact that the operated patients had more serious reflux from the beginning.

“The results show that effective medical or surgical treatment of reflux prevents cancer of the esophagus. But because the individual’s risk of developing esophageal cancer is low, even in those with reflux disease, the results do not justify treating reflux solely as a cancer-preventive measure. The symptoms and complications of reflux disease should continue to govern treatment,” said John Maret-Ouda, physician and scientist at the Department of Molecular Medicine and Surgery at Karolinska Institutet in Sweden and the first author of the study.

However, he pointed out that for the small percentage of people with severe reflux in combination with other risk factors for esophageal cancer, such as obesity, male gender and mature age, effective and continuous medical treatment or an operation to treat reflux is recommended.

“Previous research results have shown poor cancer-preventive effects from anti-reflux surgery. The difference now is that for the first time we can show statistically significant results because we have a sufficiently large study with a long follow-up period of over 15 years following the operation,” said Jesper Lagergren, consultant surgeon and professor at the Department of Molecular Medicine and Surgery, Karolinska Institutet, who led the study.

Image Credit: Getty

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