Association between medications that relax the lower esophageal sphincter and risk for esophageal adenocarcinoma.

Abstract:

BACKGROUND:The incidence of esophageal adenocarcinoma is increasing rapidly. Gastroesophageal reflux is a strong risk factor for this disease. The increase in incidence of esophageal adenocarcinoma coincided with the introduction of medications that promote reflux by relaxing the lower esophageal sphincter (LES), such as nitroglycerin, anticholinergics, beta-adrenergic agonists, aminophyllines, and benzodiazepines. OBJECTIVE:To test the possible association between use of LES-relaxing medications and risk for adenocarcinoma of the esophagus and gastric cardia. DESIGN:A nationwide population-based case-control study with in-person interviews. SETTING:Sweden, 1995 through 1997. PATIENTS:189 patients with newly diagnosed esophageal adenocarcinoma, 262 with adenocarcinoma of the gastric cardia, and 167 with esophageal squamous-cell carcinoma were compared with 820 population-based controls. MEASUREMENTS:Estimated incidence rate ratios, calculated by using multivariate logistic regression from case-control data with adjustment for potential confounding. RESULTS:Past use of LES-relaxing drugs was positively associated with risk for esophageal adenocarcinoma. Among daily, long-term users (>5 years) of LES-relaxing drugs, the estimated incidence rate ratio was 3.8 (95% CI, 2.2 to 6.4) compared with persons who had never used these drugs. Drugs of all classes contributed to the increased risk, but the association was particularly strong for anticholinergics. Short-term use of other types of LES-relaxing drugs did not seem to be strongly associated with risk. The association almost disappeared after adjustment for reflux symptoms, indicating that promotion of reflux is the link between use of LES-relaxing drugs and esophageal adenocarcinoma. If 15,490 men in any age group take LES-relaxing drugs daily for 5 years, 1 additional case of adenocarcinoma would be expected (number needed to treat for harm); in men older than 60 years of age, the number needed to treat for harm is 5,570. Assuming a causal relation, about 10% of the esophageal adenocarcinomas occurring in the population may be attributable to intake of LES-relaxing drugs. Cardia adenocarcinoma and esophageal squamous-cell carcinoma were not associated with use of LES-relaxing drugs. CONCLUSIONS:The widespread use of LES-relaxing drugs may have contributed to the increasing incidence of esophageal adenocarcinoma.

journal_name

Ann Intern Med

authors

Lagergren J,Bergström R,Adami HO,Nyrén O

doi

10.7326/0003-4819-133-3-200008010-00007

subject

Has Abstract

pub_date

2000-08-01 00:00:00

pages

165-75

issue

3

eissn

0003-4819

issn

1539-3704

pii

200008010-00007

journal_volume

133

pub_type

杂志文章
  • Community-based urine screening for Chlamydia trachomatis with a ligase chain reaction assay.

    abstract:BACKGROUND:Urine tests for Chlamydia trachomatis permit expansion of screening beyond traditional clinic environments. Prevention of infection in teenagers is a high priority. OBJECTIVE:To define the prevalence of C. trachomatis among teenagers by using the ligase chain reaction assay on urine specimens and to evaluat...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/0003-4819-127-9-199711010-00004

    authors: Marrazzo JM,White CL,Krekeler B,Celum CL,Lafferty WE,Stamm WE,Handsfield HH

    更新日期:1997-11-01 00:00:00

  • Asymptomatic glomerulonephritis after nonstreptococcal upper respiratory infections.

    abstract::Two hundred forty previously healthy military personnel with nonstreptococcal upper respiratory infections were prospectively studied to define the incidence and clinicopathologic characteristics of possible virus-associated glomerulonephritis. Nine patients without preceding streptococcal infection had erythrocyte ca...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/0003-4819-91-5-697

    authors: Smith MC,Cooke JH,Zimmerman DM,Bird JJ,Feaster BL,Morrison RE,Reimann BE

    更新日期:1979-11-01 00:00:00

  • Is antimicrobial prophylaxis of urinary tract infections cost effective?

    abstract::Antimicrobial prophylaxis prevents recurrent urinary tract infections in susceptible women, but its cost effectiveness has not been studied. In a recent placebo-controlled trial of urinary prophylaxis, we also assessed cost effectiveness using a decision analysis model. In our hospital the direct cost of 1 patient yea...

    journal_title:Annals of internal medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.7326/0003-4819-94-2-251

    authors: Stamm WE,McKevitt M,Counts GW,Wagner KF,Turck M,Holmes KK

    更新日期:1981-02-01 00:00:00

  • Institutional Variation in Quality of Cardiovascular Implantable Electronic Device Implantation: A Cohort Study.

    abstract:Background:Cardiovascular implantable electronic devices (CIEDs) are associated with procedure-related complications, yet little is known about variation in complication rates among institutions that may suggest disparities in care quality. Objective:To assess institutional variation in risk-standardized complication ...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/M18-2810

    authors: Ranasinghe I,Labrosciano C,Horton D,Ganesan A,Curtis JP,Krumholz HM,McGavigan A,Hossain S,Air T,Hariharaputhiran S

    更新日期:2019-09-03 00:00:00

  • Pituitary enlargement, pituitary failure, and primary hypothyroidism.

    abstract::Enlargement of the pituitary gland associated with primary hypothyroidism was observed in two patients. Serum thyroid-stimulating hormone (TSH) concentration and the TSH response to thyrotropin-releasing hormone were increased in both. Other pituitary function tests were subnormal in both patients, suggesting that a t...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/0003-4819-85-2-195

    authors: Vagenakis AG,Dole K,Braverman LE

    更新日期:1976-08-01 00:00:00

  • Combination therapy with zidovudine and didanosine compared with zidovudine alone in HIV-1 infection.

    abstract:OBJECTIVE:To assess safety, pharmacokinetics, and in-vivo virologic activity of five different combination regimens of zidovudine and didanosine compared with zidovudine alone in patients with human immunodeficiency virus type 1 (HIV-1) infection. DESIGN:Open-label, partially randomized, dose-ranging study. SETTING:U...

    journal_title:Annals of internal medicine

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.7326/0003-4819-119-8-199310150-00003

    authors: Collier AC,Coombs RW,Fischl MA,Skolnik PR,Northfelt D,Boutin P,Hooper CJ,Kaplan LD,Volberding PA,Davis LG,Henrard DR,Weller S,Corey L

    更新日期:1993-10-15 00:00:00

  • Human immunodeficiency virus (HIV) antigenemia (p24) in the acquired immunodeficiency syndrome (AIDS) and the effect of treatment with zidovudine (AZT).

    abstract::Infection with human immunodeficiency virus (HIV) may cause viral antigenemia, detected primarily as p24 viral core protein. Among 16 patients with the acquired immunodeficiency syndrome (AIDS) or AIDS-related complex studied serially, 12 had or developed antigenemia ranging from 16 to 3006 pg/mL in plasma. The level ...

    journal_title:Annals of internal medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.7326/0003-4819-108-2-175

    authors: Jackson GG,Paul DA,Falk LA,Rubenis M,Despotes JC,Mack D,Knigge M,Emeson EE

    更新日期:1988-02-01 00:00:00

  • Prediction Models of Mortality in Acute Pancreatitis in Adults: A Systematic Review.

    abstract:Background:Acute pancreatitis (AP) varies in severity, prompting development of systems aimed at predicting prognosis to help guide therapy. Although several prediction approaches are available, their test characteristics and clinical utility are not completely understood. Purpose:To evaluate the test characteristics ...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章,评审

    doi:10.7326/M16-0650

    authors: Di MY,Liu H,Yang ZY,Bonis PA,Tang JL,Lau J

    更新日期:2016-10-04 00:00:00

  • A short course of prednisolone in chronic type B hepatitis. Report of a randomized, double-blind, placebo-controlled trial.

    abstract::Fifteen patients with chronic type B hepatitis were treated with corticosteroids in a randomized, double-blind, placebo-controlled trial lasting 28 days. Ten patients received prednisolone, 60 mg/d for 2 weeks, then 30 mg/d for another 2 weeks; 5 patients received placebo. Serum aminotransferase levels decreased signi...

    journal_title:Annals of internal medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.7326/0003-4819-104-1-12

    authors: Hoofnagle JH,Davis GL,Pappas SC,Hanson RG,Peters M,Avigan MI,Waggoner JG,Jones EA,Seeff LB

    更新日期:1986-01-01 00:00:00

  • Toxic shock syndrome surveillance in the United States, 1980 to 1981.

    abstract::Between 1 January 1980 and 18 October 1981, investigators from the Centers for Disease Control collected information on 1407 cases of toxic shock syndrome using a nationwide passive surveillance system. Ninety-two percent of the reported cases were associated with menstruation. Information available on the type of men...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/0003-4819-96-6-875

    authors: Reingold AL,Hargrett NT,Shands KN,Dan BB,Schmid GP,Strickland BY,Broome CV

    更新日期:1982-06-01 00:00:00

  • Diuretics, beta-blockers, and the risk for sudden cardiac death in hypertensive patients.

    abstract:OBJECTIVE:To determine whether the use of non-potassium-sparing diuretics and beta-blockers is associated with an excess risk for sudden cardiac death in hypertensive patients. DESIGN:Case-control study. SETTING:Rotterdam, the Netherlands. PATIENTS:257 case-patients who had died suddenly while receiving drug therapy...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/0003-4819-123-7-199510010-00001

    authors: Hoes AW,Grobbee DE,Lubsen J,Man in 't Veld AJ,van der Does E,Hofman A

    更新日期:1995-10-01 00:00:00

  • Good enough: a primer on the analysis and interpretation of noninferiority trials.

    abstract::Active-control noninferiority trials are being performed with increasing frequency when standard placebo-controlled trials are considered unethical. Three attributes are optimally required to establish noninferiority: 1) The treatment under consideration exhibits therapeutic noninferiority to the active control; 2) th...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/0003-4819-145-1-200607040-00011

    authors: Kaul S,Diamond GA

    更新日期:2006-07-04 00:00:00

  • Antigenemia detected by radioimmunoassay in systemic aspergillosis.

    abstract::Because of difficulties in antemortem diagnosis of systemic aspergillosis, a radioimmunoassay to an Aspergillus fumigatus carbohydrate was developed and evaluated in patients with mycotic or bacterial infections. Antigenemia was detected in sera obtained antemortem from four of seven patients with systemic aspergillos...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/0003-4819-92-6-793

    authors: Weiner MH

    更新日期:1980-06-01 00:00:00

  • Occupationally acquired infections in health care workers. Part I.

    abstract:BACKGROUND:Health care workers are at occupational risk for a vast array of infections that cause substantial illness and occasional deaths. Despite this, few studies have examined the incidence, prevalence, or exposure-associated rates of infection or have considered infection-specific interventions recommended to mai...

    journal_title:Annals of internal medicine

    pub_type: 历史文章,杂志文章,评审

    doi:10.7326/0003-4819-125-10-199611150-00007

    authors: Sepkowitz KA

    更新日期:1996-11-15 00:00:00

  • Effect of starting age of physical activity on bone mass in the dominant arm of tennis and squash players.

    abstract:OBJECTIVE:To determine in female tennis and squash players the effect of biological age (that is, the starting age of playing relative to the age at menarche) at which tennis or squash playing was started on the difference in bone mineral content between the playing and non-playing arms. DESIGN:Cross-sectional study. ...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/0003-4819-123-1-199507010-00003

    authors: Kannus P,Haapasalo H,Sankelo M,Sievänen H,Pasanen M,Heinonen A,Oja P,Vuori I

    更新日期:1995-07-01 00:00:00

  • Formulating questions and locating primary studies for inclusion in systematic reviews.

    abstract::Much time and effort are spent on designing primary research studies. Similar care must be given to planning systematic reviews. The review should be based on an important, well-focused question that is relevant to patient care. By formulating the question properly, the criteria that primary studies must meet to be in...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章,评审

    doi:10.7326/0003-4819-127-5-199709010-00008

    authors: Counsell C

    更新日期:1997-09-01 00:00:00

  • Fluconazole prophylaxis of fungal infections in patients with acute leukemia. Results of a randomized placebo-controlled, double-blind, multicenter trial.

    abstract:OBJECTIVE:To evaluate the efficacy and safety of fluconazole for prevention of fungal infections. DESIGN:A randomized, placebo-controlled, double-blind, multicenter trial. PATIENTS:Adults (257) undergoing chemotherapy for acute leukemia. INTERVENTION:Patients were randomly assigned to receive either fluconazole (400...

    journal_title:Annals of internal medicine

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.7326/0003-4819-118-7-199304010-00003

    authors: Winston DJ,Chandrasekar PH,Lazarus HM,Goodman JL,Silber JL,Horowitz H,Shadduck RK,Rosenfeld CS,Ho WG,Islam MZ,Buell DN

    更新日期:1993-04-01 00:00:00

  • Feasibility and utility of adding disease-specific outcome measures to administrative databases to improve disease management.

    abstract::To increase the utility of administrative databases, it has been recommended that they include disease-specific, patient-centered outcome measures. This paper reviews practical and theoretical considerations and the critical evidence to support this recommendation. The strengths and weaknesses of the recommended appro...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章,评审

    doi:10.7326/0003-4819-127-8_part_2-199710151-00060

    authors: Liang MH,Shadick N

    更新日期:1997-10-15 00:00:00

  • Lost in transition: challenges and opportunities for improving the quality of transitional care.

    abstract::Transitional care has been defined as a set of actions designed to ensure the coordination and continuity of health care as patients transfer between different locations or different levels of care in the same location. Transitional care, which primarily concerns the relatively brief time interval that begins with pre...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/0003-4819-141-7-200410050-00009

    authors: Coleman EA,Berenson RA

    更新日期:2004-10-05 00:00:00

  • Human babesiosis on Nantucket Island. Clinical features.

    abstract::Between 20 July and 15 Octoboer 1975, five cases of human infection with Babesia microti were diagnosed on Nantucket Island, Massachusetts. The illness was characterized by fever, drenching sweats, shaking chills, myalgia, arthralgia, extreme fatigue, and a mild-to-moderate hemolytic anemia. None of the patients had a...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/0003-4819-86-1-6

    authors: Reubush TK 2nd,Cassaday PB,Marsh HJ,Lisker SA,Voorhees DB,Mahoney EB,Healy GR

    更新日期:1977-01-01 00:00:00

  • Harms Reporting in Randomized Controlled Trials of Interventions Aimed at Modifying Microbiota: A Systematic Review.

    abstract:Background:Probiotics, prebiotics, and synbiotics are used increasingly, although the safety and potential harms of these interventions are poorly understood. Purpose:To examine how harms-related information is reported in publications of randomized controlled trials (RCTs) of probiotics, prebiotics, and synbiotics. ...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/M18-0343

    authors: Bafeta A,Koh M,Riveros C,Ravaud P

    更新日期:2018-08-21 00:00:00

  • Hypomagnesemic hypocalcemia secondary to renal magnesium wasting.

    abstract::Two patients developed severe hypomagnesemia, hypocalcemia, and hypokalemia as a result of renal wasting of magnesium and potassium shortly after being treated with large doses of gentamicin. When therapy with gentamicin was discontinued renal loss of magnesium and potassium ceased, and serum calcium, magnesium, and p...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/0003-4819-82-5-646

    authors: Bar RS,Wilson HE,Mazzaferri EL

    更新日期:1975-05-01 00:00:00

  • Influenza immunization in systemic lupus eruthematosus. A double-blind trial.

    abstract::Forty patients with systemic lupus erythematosus randomly received inactivated bivalent (A/NJ and A/Victoria) influenza vaccine or saline in a double-blind study. During 20 weeks of follow-up, no deterioration in major organ function or increase in disease flares was observed in the immunized group as compared with th...

    journal_title:Annals of internal medicine

    pub_type: 临床试验,杂志文章

    doi:10.7326/0003-4819-88-6-729

    authors: Williams GW,Steinberg AD,Reinertsen JL,Klassen LW,Decker JL,Dolin R

    更新日期:1978-06-01 00:00:00

  • In the clinic. Hypothyroidism.

    abstract::The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including PIER (Physicians' Information and Education Resource) and MKSAP (Medical Knowledge and Self Assessment Program). Annals of Internal Medicine editors develop In the Clinic f...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章,评审

    doi:10.7326/0003-4819-151-11-200912010-01006

    authors: McDermott MT

    更新日期:2009-12-01 00:00:00

  • Pulmonary function and gastroesophageal reflux in systemic sclerosis.

    abstract:OBJECTIVE:To determine the relations among esophageal dysfunction, gastroesophageal reflux, and lung involvement in patients with systemic sclerosis. DESIGN:Retrospective review of esophageal motility, esophageal pH, and pulmonary function data. SETTING:University hospital outpatient clinic and community. PATIENTS:3...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/0003-4819-121-1-199407010-00002

    authors: Troshinsky MB,Kane GC,Varga J,Cater JR,Fish JE,Jimenez SA,Castell DO

    更新日期:1994-07-01 00:00:00

  • Comparison of the quality of ambulatory care for fee-for-service and prepaid patients.

    abstract:OBJECTIVE:To determine whether the quality of care for common ambulatory conditions is adversely affected when physicians are provided with incentives to limit the use of health services. DESIGN:Retrospective cohort study over a 2-year period. SETTING:Four group practices that cared for both fee-for-service patients ...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/0003-4819-115-5-394

    authors: Udvarhelyi IS,Jennison K,Phillips RS,Epstein AM

    更新日期:1991-09-01 00:00:00

  • Implantable cardioverter-defibrillators: implications for the nonelectrophysiologist.

    abstract:PURPOSE:To review clinical scenarios in which nonelectrophysiologist physicians may interact with patients who have implantable defibrillators. DATA SOURCES:Peer-reviewed original articles and reviews addressing aspects of implantable defibrillator therapy that are relevant to the clinician. DATA SYNTHESIS:The capaci...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章,评审

    doi:10.7326/0003-4819-122-10-199505150-00007

    authors: Pinski SL,Trohman RG

    更新日期:1995-05-15 00:00:00

  • NIH conference. Asthma.

    abstract::Asthma is characterized by inflammation, reversible airway obstruction, and increased airway responsiveness to various stimuli. It has received wide public attention in recent years because of increasing morbidity and deaths, particularly among black persons. The important role of inflammation in the immunopathogenesi...

    journal_title:Annals of internal medicine

    pub_type: 共识发展会议,杂志文章,评审

    doi:10.7326/0003-4819-121-9-199411010-00011

    authors: Goldstein RA,Paul WE,Metcalfe DD,Busse WW,Reece ER

    更新日期:1994-11-01 00:00:00

  • Discussing hidden bias in observational studies.

    abstract::In observational studies or nonrandomized experiments, treated and control groups may differ in their outcomes even if the treatment has no effect; this may happen if the groups were not comparable before the start of treatment. The groups may fail to be comparable in either of two ways: They may differ with respect t...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/0003-4819-115-11-901

    authors: Rosenbaum PR

    更新日期:1991-12-01 00:00:00

  • Effects of an angiotensin-converting enzyme inhibitor on residual renal function in patients receiving peritoneal dialysis. A randomized, controlled study.

    abstract:BACKGROUND:Residual renal function is an important determinant of mortality and morbidity in patients receiving peritoneal dialysis. However, few studies have evaluated therapeutic approaches for preserving residual renal function after the initiation of dialysis. OBJECTIVE:To test the hypothesis that the angiotensin-...

    journal_title:Annals of internal medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.7326/0003-4819-139-2-200307150-00010

    authors: Li PK,Chow KM,Wong TY,Leung CB,Szeto CC

    更新日期:2003-07-15 00:00:00