The vast majority of patients in this cohort had gastroesophageal reflux disease and were undergoing therapy, mainly with proton-pump inhibitors. It is unclear how the frequency or severity of symptoms may have affected NSAID use by participants, the researchers said.
However, to their knowledge, they said, symptoms from reflux are not associated with intermediate endpoints or cancer in Barrett's esophagus, so it is unlikely that symptoms could explain the association of NSAID use with reduced risk of esophageal cancer.
The annual incidence of esophageal cancer among Barrett's esophagus patients is about 1%, and most patients never develop the malignancy, Dr. Reid wrote. However, he said, the outlook is grim if the cancer is not diagnosed early, with an overall survival rate of only 13.7%. For this reason, he said, Barrett's patients must undergo frequent endoscopic surveillance.
The findings of this study may ultimately help identify high-risk patients who require frequent surveillance and low-risk patients who need less frequent surveillance, or none, he said.