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Detection of laryngeal carcinoma in the U.S. elderly population with gastroesophageal reflux disease
Author(s) -
Riley Charles A.,
Marino Michael J.,
Hsieh MeiChin,
Wu Eric L.,
Wu XiaoCheng,
McCoul Edward D.
Publication year - 2019
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.25600
Subject(s) - medicine , gerd , laryngopharyngeal reflux , reflux , confidence interval , epidemiology , laryngoscopy , malignancy , cancer , disease , cohort , carcinoma , cohort study , larynx , population , relative risk , gastroenterology , surgery , intubation , environmental health
Background An association is suggested between gastroesophageal reflux disease (GERD) or laryngopharyngeal reflux (LPR) and malignancy of the larynx in elderly patients in the United States. Early detection with flexible fiberoptic laryngoscopy (FFL) or CT remains poorly defined. Methods The Surveillance, Epidemiology, and End Results (SEER)‐Medicare linked database was queried from 2003 to 2011.A case‐cohort design evaluated patients aged 66 and older with a diagnosis of GERD and/or LPR for the occurrence of FFL or CT within 6 months of the exposure diagnosis. Results Of a total 156 426 Medicare beneficiaries, the relative risk of early cancer diagnosis with FFL was 14.61(95% confidence interval [CI], 13.59‐15.70), corresponding to a number needed to detect (NND) a case of cancer of 13(95% CI, 13‐14). The relative risk of an early cancer diagnosis with CT was 31.83 (95% CI, 29.57‐34.26), with a NND of 5 (95% CI, 5‐5). Conclusions Early FFL and CT are associated with a higher likelihood of laryngeal cancer diagnosis in elderly individuals with a diagnosis of reflux. Screening trials are necessary to establish this relationship.