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Metabolic syndrome associated with esophageal adenocarcinoma in elderly
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Metabolic syndrome appeared associated with an increased risk for esophageal adenocarcinoma among elderly patients, study data showed.
“The incidence of esophageal adenocarcinoma has rapidly increased in the United States over the last 30 years. This malignancy is believed to arise within Barrett esophagus, a metaplasia caused by chronic exposure to gastroesophageal reflux,” Jennifer Drahos, PhD, MPH, of the division of cancer epidemiology and genetics at NCI, and colleagues wrote. “Although to our knowledge a few studies to date have demonstrated an association between Barrett esophagus and metabolic syndrome, only a single study has evaluated metabolic syndrome in relation to esophageal adenocarcinoma using multiple prospective cohorts, with the accrual of 114 cases in total.”
Drahos and colleagues used the SEER-Medicare database to identify 3,167 cases (patient age, ≥ 67.5 years) of esophageal adenocarcinoma, which were compared with individually matched controls (5:1). The researchers also compared a subset of 575 esophageal carcinoma cases with 575 Barrett esophagus controls.
The researchers observed a significant association between esophageal adenocarcinoma and metabolic syndrome (OR = 1.16; 95% CI, 1.06-1.26) compared with controls. The association occurred in men without prior gastroesophageal reflux disease, as well as among women regardless of reflux disease status.
The researchers found no association between esophageal adenocarcinoma and metabolic syndrome compared with Barrett esophagus controls (OR = 1.01; 95% CI, 0.78-1.31).
This study was the first, to the researchers’ knowledge, to demonstrate an association between metabolic syndrome and increased risk for esophageal adenocarcinoma.
“We propose that the systemic inflammation conferred by metabolic syndrome increases the risk [for] esophageal adenocarcinoma primarily by increasing the risk [for] the precursor lesion Barrett esophagus,” the researchers wrote. “Future studies should evaluate whether treating the conditions of metabolic syndrome decreases risk [for] Barrett esophagus and esophageal adenocarcinoma.” – by Andy Polhamus
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