Excessive lower oesophageal sphincter relaxation increases gastro-oesophageal acid reflux, an oesophageal adenocarcinoma risk factor. Medications that relax this sphincter (benzodiazepines, calcium channel blockers, nitrates, β2 agonists and xanthines) could promote cancer. These medications were investigated in two independent datasets. In the Scottish Primary Care Clinical Informatics Unit (PCCIU) database, a nested case-control study of oesophageal cancer was performed using GP prescription records. Conditional logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CIs) for medication use and oesophageal cancer. In UK Biobank, a cohort study was conducted using self-reported medication use. Cox regression was used to calculate hazard ratios (HRs) and 95% CIs for medication use and oesophageal cancer, and by tumour subtype. Overall, 1,979 oesophageal cancer patients were matched to 9,543 controls in PCCIU, and 355 of 475,768 participants developed oesophageal cancer in UK Biobank. None of the medications investigated were significantly associated with oesophageal cancer risk apart from β2 agonists, which were associated with increased oesophageal cancer risk in PCCIU (adjusted OR 1.38, 95% CI 1.12, 1.70) but not in UK Biobank (adjusted HR 1.21, 95% CI 0.70, 2.08). Medications that relax the lower oesophageal sphincter were not associated with oesophageal cancer, apart from β2 agonists. This increased cancer risk in β2 agonist users merits further investigation.
|Number of pages||11|
|Journal||International Journal of Cancer|
|Early online date||8 Mar 2018|
|Publication status||Published - 1 Jul 2018|
- β2 agonists
- Oesophageal cancer
- Calcium channel blockers
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Peter Murchie, BSc (Med Sci), MBChB, MSc, MRCGP, CertMgmt (Open), PhD
- School of Medicine, Medical Sciences & Nutrition, Applied Health Sciences - Personal Chair (Clinical)
- School of Medicine, Medical Sciences & Nutrition, Centre for Health Data Science
- School of Medicine, Medical Sciences & Nutrition, Grampian Data Safe Haven (DaSH)
- Institute of Applied Health Sciences
Person: Clinical Academic