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World J Gastroenterol. Jan 21, 2015; 21(3): 815-819
Published online Jan 21, 2015. doi: 10.3748/wjg.v21.i3.815
Gastroesophageal reflux disease and non-esophageal cancer
Fernando AM Herbella, Sebastião Pannocchia Neto, Ilka Lopes Santoro, Licia Caldas Figueiredo
Fernando AM Herbella, Sebastião Pannocchia Neto, Department of Surgery, Federal University of Sao Paulo, Sao Paulo 04037-003, Brazil
Ilka Lopes Santoro, Licia Caldas Figueiredo, Pneumology Division, Department of Medicine, Federal University of Sao Paulo, Sao Paulo 04037-003, Brazil
Author contributions: Both Herbella FAM and Neto SP designed research and wrote the paper; and all authors performed research and analyzed data.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Fernando AM Herbella, MD, Department of Surgery, Federal University of Sao Paulo, Rua Diogo de Faria 1087 cj 301, Sao Paulo 04037-003, Brazil. herbella.dcir@epm.br
Telephone: +55-11-99922824 Fax: +55-11-99922824
Received: July 28, 2014
Peer-review started: July 29, 2014
First decision: August 15, 2014
Revised: August 29, 2014
Accepted: October 15, 2014
Article in press: October 15, 2014
Published online: January 21, 2015
Processing time: 175 Days and 21.9 Hours
Abstract

The association of gastroesophageal reflux disease (GERD) and esophageal cancer is well known. The carcinogenic properties of the gastroduodenal contents may also lead to cancer in target organs for GERD especially considering that they do not have intrinsic protective mechanisms as found in the esophagus. This review focuses on the putative relation between GERD and non-esophageal cancer. Most of the papers reviewed are far from ideal to prove the relationship of extra-esophageal cancer and GERD since a small number of patients is presented, most do not control cases based on tobacco usage and obesity, and the diagnosis of GERD is variable, not always from an objective measurement such as pH monitoring but relying on symptoms in most reports. Nevertheless, head and neck and lung cancer have a growing incidence parallel to GERD and a shift towards non-smoking, female gender and adenocarcinoma (compared to squamous cell carcinoma) is arising, similar to the example of esophageal cancer with the exception of the female gender.

Keywords: Gastroesophageal reflux; Cancer; Pharynx; Larynx; Trachea; Lung

Core tip: Gastroesophageal reflux disease (GERD) is a very prevalent disease with a rising incidence. The disease is certainly linked to the pathogenesis of esophageal adenocarcinoma originated in the Barrett’s esophagus. The carcinogenic properties of the gastroduodenal contents may also lead to cancer in target organs for GERD, especially considering that they do not have intrinsic protective mechanisms as found in the esophagus. Although strong conclusions cannot be drawn due to lack of good quality published studies, GERD may also be linked to the pathogenesis of head and neck and lung cancers.