NSAIDS Reduce Risk of Esophageal Cancer
by C.H. Weaver M.D.
According to a recent early on-line publication from Lancet Oncology, regular use of non-steroidal anti-inflammatory agents (NSAIDS) may reduce the risk of esophageal cancer among patients with Barrett’s esophagus.
The esophagus is a tube that connects the back of the mouth to the stomach. In Barrett’s esophagus, the lining of the esophagus contains cells that appear abnormal under a microscope; these cells are considered to be pre-cursors to esophageal cancer.
Patients diagnosed with Barrett’s esophagus typically undergo regular screening for esophageal cancer with scheduled endoscopy procedures. An endoscopy involves placement of a lighted tube down a patient’s throat through the esophagus so a physician can visually inspect the lining of the esophagus and remove any suspicious looking tissue.
Since cure rates for esophageal cancer are poor once the cancer has spread from its site of origin, preventing its development is an appealing approach for high-risk patients.
Results from recent studies have indicated that NSAIDs may provide protection against the development of some types of cancers. Researchers continue to evaluate the use of NSAIDs as preventive agents. NSAIDs interfere with inflammatory pathways in the body, which have been implicated in the development or growth of certain cancers.
Researchers from the University of Washington and the Fred Hutchinson Cancer Research Center recently conducted a clinical study to evaluate the use of NSAIDs and their potential to reduce the risk of esophageal cancer in patients with Barrett’s esophagus. This study included 350 people diagnosed with Barrett’s esophagus who were followed for over 5 years.
Patients underwent regular endoscopy screening procedures and were interviewed about lifestyle habits and variables such as age and weight. Patients were classified according to their NSAID use: Current users (NSAID use at least once a week for a 6-month minimum at the time of or within a year of initial interview); former users (NSAID use at least once a week for a 6-month minimum, but not within a year of initial interview); or never users (never used NSAIDs once a week or more for at least 6 months).
NSAID use appeared to reduce the risk of developing esophageal cancer in former and current users:
- Compared with never-users, current NSAID users had a 68% reduced risk of developing esophageal cancer.
- Compared with never-users, former NSAID users had a 30% reduced risk of developing esophageal cancer.
- The overall rates of developing esophageal cancer within the 5-year follow-up were 14.3% for never-users, 9.7% for former users, and 6.6% for current users.
The researchers concluded that regular NSAID use may reduce the risk of developing esophageal cancer among patients with Barrett’s esophagus. Patients with Barrett’s esophagus should speak with their physician regarding their individual risks and benefits of regular NSAID use.
Reference: Vaughan T, Dong L, Blount P, et al. Non-steroidal anti-inflammatory drugs and risk of neoplastic progression in Barrett’s oesophagus: a prospective study. Lancet Oncology. Early on-line publication November 8, 2005. DOI:10.1016/S1470-2045(05)70431-9