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Daily use of non‐steroidal anti‐inflammatory drugs is less frequent in patients with Barrett's oesophagus who develop an oesophageal adenocarcinoma
Author(s) -
Tsibouris P.,
Hendrickse M. T.,
Isaacs P. E. T.
Publication year - 2004
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2004.02150.x
Subject(s) - medicine , aspirin , gastroenterology , adenocarcinoma , barrett's oesophagus , odds ratio , cancer
Summary Background : Non‐steroidal anti‐inflammatory drugs use may protect against development of oesophageal adenocarcinoma. Aim : To define the consequences of non‐steroidal anti‐inflammatory drugs use in patients with Barrett's oesophagus. Methods : Records of all Barrett's oesophagus/oesophageal adenocarcinoma patients examined in Blackpool‐Wyre‐Fylde area were reviewed. All surviving patients completed validated questionnaires. Results : Use of non‐steroidal anti‐inflammatory drugs of any type and at any frequency was more prevalent in Barrett's oesophagus patients [147 (38%) Barrett's oesophagus vs. 30 (26%) oesophageal adenocarcinoma, P = 0.02]. Daily use of non‐steroidal anti‐inflammatory drugs was more prevalent in Barrett's oesophagus patients [88 (23%) Barrett's oesophagus vs. 14 (12%) oesophageal adenocarcinoma, P = 0.02], due to more prevalent consumption of non‐aspirin non‐steroidal anti‐inflammatory drugs [48 (13%) Barrett's oesophagus vs. four (4%) oesophageal adenocarcinoma, P =0.009]. There was no difference between the two groups in usage of either daily low‐dose aspirin or of occasional non‐steroidal anti‐inflammatory drugs. In logistic regression analysis any use of non‐steroidal anti‐inflammatory drugs [odds ratio (OR) = 0571 (95% CI: 0.359–0.909), P = 0.018] and daily use of non‐aspirin non‐steroidal anti‐inflammatory drugs [OR = 0.297 (95% CI: 0.097–0.911), P = 0.034] were significant protective factors. Non‐steroidal anti‐inflammatory drugs use did not affect the survival of oesophageal adenocarcinoma patients. Oesophageal adenocarcinoma and Barrett's oesophagus consuming non‐steroidal anti‐inflammatory drugs did not differ in upper gastrointestinal bleeding [26 (15%) non‐steroidal anti‐inflammatory drugs consumers vs. 29 (9%) non‐consumers, P = 0.08], oesophageal ulcers [31 (18%) non‐steroidal anti‐inflammatory drug consumers vs. 49 (15%) non‐consumers, P = 0.43] or stricturing [19 (11%) non‐steroidal anti‐inflammatory drug consumers vs. 41 (13%) non‐consumers, P = 0.58]. Conclusions : (i) Daily use of non‐steroidal anti‐inflammatory drugs is more prevalent in Barrett's oesophagus than oesophageal adenocarcinoma patients, because of a more prevalent use of non‐aspirin non‐steroidal anti‐inflammatory drugs. (ii) Use of non‐steroidal anti‐inflammatory drugs in Barrett's oesophagus patients is safe if acid suppression is adequate.