Background: Risk factors for adenocarcinoma of the oesophagus (OAC) and gastric cardia (GCA) are not yet established. Aim: To compare environmental risk factors between patients with OAC and GCA. Methods: One-hundred and twenty-six patients with OAC, 43 with GCA and 57 with squamous cell carcinoma filled out a questionnaire with information on demographic and lifestyle characteristics, physical activity levels, family history, gastro-oesophageal reflux disease symptoms and medication use. Results: OAC and GCA patients were similar with regard to male predominance and age, alcohol intake and smoking, use of fruits and vegetables, body posture and occupational activities (P > 0.05). GCA patients less often had heartburn compared with OAC patients [odds ratio (OR) 0.5, 95% confidence interval (CI) 0.2-0.96] and had these symptoms less frequently and for a shorter period (OR 0.3, CI 0.1-1.0 and OR 0.1, CI 0.03-0.6, respectively). Former and current aspirin use was lower among GCA patients than OAC patients (OR 0.2, CI 0.05-0.7 and OR 0.4, CI 0.1-0.9, respectively), whereas no difference in non-steroidal anti-inflammatory drug use was detected. Conclusion: Although OAC and GCA share several environmental risk factors, OAC is more frequently associated with a history of gastro-oesophageal reflux disease, suggesting a more important role for gastro-oesophageal reflux in OAC compared with GCA.

dx.doi.org/10.1111/j.1365-2036.2007.03344.x, hdl.handle.net/1765/35934
Alimentary Pharmacology and Therapeutics
Erasmus MC: University Medical Center Rotterdam

de Jonge, P.J.F, Wolters, L.M.M, Steyerberg, E.W, van Dekken, H, Kusters, J.G, Kuipers, E.J, & Siersema, P.D. (2007). Environmental risk factors in the development of adenocarcinoma of the oesophagus or gastric cardia: A cross-sectional study in a Dutch cohort. Alimentary Pharmacology and Therapeutics, 26(1), 31–39. doi:10.1111/j.1365-2036.2007.03344.x