Esophageal Adenocarcinoma: The Influence of Medications Used to Treat Comorbidities on Cancer Prognosis

Clin Gastroenterol Hepatol. 2015 Dec;13(13):2225-32. doi: 10.1016/j.cgh.2015.03.028. Epub 2015 Mar 31.

Abstract

Esophageal adenocarcinoma has undergone a continuous rise in incidence since the early 1970s and is the fastest rising cancer among white men in the United States. Epidemiologic studies have demonstrated that medications commonly used to treat multiple chronic conditions (for example, aspirin, non-aspirin nonsteroidal anti-inflammatory drugs, and statins) as well as powerful acid suppressants such as proton pump inhibitors are associated with a reduced risk of esophageal adenocarcinoma. The chemopreventive potential of these classes of medications appears to be especially applicable to persons with Barrett's esophagus, the only known premalignant condition for esophageal adenocarcinoma. However, it is not known whether these medications also influence cancer recurrence and cancer-specific mortality in persons diagnosed with esophageal adenocarcinoma. This is an important question because most patients with esophageal adenocarcinoma have 1 or more comorbid conditions at the time of their cancer diagnosis and are receiving medication to treat these conditions. This article summarizes the evidence on the associations between 4 commonly used classes of medications and (1) risk of developing esophageal adenocarcinoma and Barrett's esophagus and (2) risk of cancer recurrence and cancer-specific mortality in patients with esophageal adenocarcinoma.

Keywords: Aspirin; Barrett’s Esophagus; Cancer Outcomes; Metformin; NSAIDs; Statins; Survival.

Publication types

  • Review

MeSH terms

  • Adenocarcinoma / epidemiology*
  • Adenocarcinoma / mortality
  • Adenocarcinoma / prevention & control
  • Anti-Inflammatory Agents / therapeutic use
  • Anticholesteremic Agents / therapeutic use
  • Barrett Esophagus / complications
  • Chemoprevention / methods*
  • Esophageal Neoplasms / epidemiology*
  • Esophageal Neoplasms / mortality
  • Esophageal Neoplasms / prevention & control
  • Humans
  • Male
  • Prognosis
  • Proton Pump Inhibitors / therapeutic use
  • Recurrence
  • Survival Analysis
  • United States / epidemiology

Substances

  • Anti-Inflammatory Agents
  • Anticholesteremic Agents
  • Proton Pump Inhibitors