Gastroesophageal reflux disease and upper aerodigestive tract cancer risk: A meta-analysis of site-specific associations.

Abstract

e18106 Background: Gastroesophageal reflux disease (GERD), which affects approximately 20% of the U.S. population, has been implicated as a potential risk factor for upper aerodigestive tract (UADT) cancers, such as laryngeal cancers. This systematic review and meta-analysis aimed to evaluate the association between GERD and UADT cancers. Methods: A systematic review and meta-analysis were conducted to assess the relationship between GERD and UADT cancers. Random-effects models were used to calculate pooled relative risks (RRs) and 95% confidence intervals (CIs) for site-specific associations. Results: A total of 17 studies were included, including 12 case control studies and 5 cohort studies. Meta-analysis revealed a significant association between GERD and laryngeal cancer (RR = 1.65, 95% CI = 1.19–2.31, n = 14). Subgroup analysis of laryngeal cancer studies demonstrated a stronger association in cohort studies (RR = 2.41, 95% CI = 1.21–4.80, n = 3) compared to case-control studies (RR = 1.50, 95% CI = 1.10–2.06, n = 11). Geographic differences were also observed, with studies in the U.S. showing a significant association (RR = 1.65, 95% CI = 1.23–2.23, n = 8) compared to those conducted outside the U.S. (RR = 1.70, 95% CI = 0.86–3.36, n = 6). No significant associations were observed for pharyngeal cancer (RR = 1.40, CI = 0.74 –2.67), oropharyngeal cancer (RR = 1.91, 95% CI = 0.30–12.33, n = 3), hypopharyngeal cancer (RR = 2.05, 95% CI = 0.25–16.54, n = 3), or esophageal cancer (RR = 1.77, 95% CI = 0.36–8.59, n = 3). Conclusions: GERD is significantly associated with an increased risk of laryngeal cancer, with stronger associations observed in cohort studies and U.S based studies. No significant associations were found for GERD and other UADT cancers, including oropharyngeal, hypopharyngeal, and esophageal cancers. These findings highlight the need for further research to clarify GERD’s role in cancer development and address gaps in prevention strategies.