Diabetes May Raise Esophageal Cancer Risk

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Diabetes patients with Barretts esophagus may face greater likelihood of esophageal cancer

October 21, 2013 / Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

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(dailyRx News) Heartburn isn’t always a dire health matter, but if stomach acid repeatedly enters the esophagus, it can lead to a more serious condition and possibly cancer.

Chronic exposure to gastric acid can damage and eventually change the cells lining the esophagus (tube that connects the mouth to the stomach). This condition is called Barrett’s esophagus, and it raises the chances of getting cancer.

A new study found that among patients with Barrett’s esophagus, those who also have diabetes may face an even greater risk of getting esophageal cancer.

"See a doctor if you have chronic heartburn."

Prashanthi Thota, MD, of the Department of Gastroenterology and Hepatology at the Cleveland Clinic, led this investigation of 1,623 patients who were diagnosed with Barrett’s esophagus.

Of these individuals, 274 either had diabetes at the start of the study or were later diagnosed with the disease during the research.

After a 16-month follow-up, Dr. Thota and her colleagues observed that 17.9 percent of those with diabetes developed precancerous changes in cells (called high grade dysplasia), compared to 9.7 percent of patients without diabetes.

The authors of this study noted that diabetes patients tended to be older with an average age of 64, compared to age 59 among those without diabetes.

Also, diabetes patients were much more likely to have high blood pressure — about eight out of 10 had hypertension, compared to about one-third of those without diabetes.

Dr. Thota told dailyRx News that these results do not mean that diabetes patients are at a greater risk of getting Barrett’s esophagus or esophageal cancer.

“The study is about Barrett's patients who have diabetes, not all diabetic patients,” Dr. Thota said. “The available data is too premature to make any specific recommendations at this time.”

Gastroesophageal reflux disease (GERD) is a major risk factor for getting Barrett’s esophagus. About 10 to 20 million people in the US are suspected of having GERD, according to the Society of Thoracic Surgeons, and an estimated 10 to 15 percent of them develop Barrett’s, according to the American Society of Gastrointestinal Endoscopy (ASGE).

This chronic condition causes stomach acid to back up into the esophagus, the tube that carries food, liquids and saliva from the mouth to the stomach. Barrett’s tends to occur in middle-aged Caucasian men who have had heartburn for many years.

ASGE says that patients can effectively control GERD with medications and possibly surgery, but Barrett’s esophagus cannot be reversed.

This study's results and abstract were presented at the annual meeting of the American College of Gastroenterology in October. The research has not yet been published in a peer-reviewed journal.