Reflux disease, which includes acid regurgitation and heartburn, has been associated with an increased risk of esophageal cancer. However, a recent study in The BMJ by Karolinska Institutet researchers reveals that most patients with reflux disease do not have a higher cancer risk. A comprehensive study across three Nordic countries indicates that the elevated cancer risk is only observed in patients with specific esophageal mucosa changes detected through gastroscopy.

Acidic contents leakage to esophagus causes reflux

The study’s first author, Dag Holmberg, emphasised the significance of the study findings considering reflux disease is a widespread condition, and many patients appear to have a healthy mucus membrane during gastroscopic examinations.

Reflux disease involves the leakage of acidic stomach contents into the esophagus, potentially leading to esophagitis. Gastroscopy is used to diagnose this inflammation. While it’s well-known that reflux disease raises the risk of esophageal cancer, the exact cancer risk in patients with healthy mucosa has been unclear.

It is important to note that reflux symptoms may be intermittent but usually persist, leading many patients to seek medical help and undergo repeated gastroscopies for detecting mucosal issues or early-stage cancer.

Frequent gastroscopies not recommend for healthy esophageal mucosa

The study indicates that frequent gastroscopies may not be needed for individuals with reflux disease and a healthy esophageal lining. Dr. Holmberg believes these results can offer reassurance to this patient population and help inform general practitioners in their treatment approach.

In this study, data from national health registries in Sweden, Denmark, and Finland were analyzed, involving over 285,000 individuals with reflux disease but no signs of esophagitis. They were monitored for up to 31 years, during which the researchers tracked esophageal cancer cases. The study compared the cancer risk in these patients to that of individuals in the general population with similar age and gender characteristics from the same three countries.

The findings showed that patients with reflux disease and a normal esophageal membrane did not exhibit an elevated risk of esophageal cancer. Going forward researchers plan to study factors linked to cancer in reflux disease individuals besides esophagitis.