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Reevaluation of gastroesophageal reflux disease as a risk factor for laryngeal cancer§

Authors

  • David O. Francis MD, MS,

    Corresponding author
    1. Health Service Research and Development, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, U.S.A
    2. Department of Otolaryngology–Head and Neck Surgery , University of Washington, Seattle, Washington, U.S.A
    • Vanderbilt Voice Center, Medical Center East, South Tower, 1215 21st Avenue South, Suite 7302, Nashville, TN 37232-8783
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  • Charles Maynard PhD,

    1. Health Service Research and Development, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, U.S.A
    2. Department of Health Services, University of Washington, Seattle, Washington, U.S.A
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  • Ernest A. Weymuller MD,

    1. Department of Otolaryngology–Head and Neck Surgery , University of Washington, Seattle, Washington, U.S.A
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  • Gayle Reiber MPH, PhD,

    1. Health Service Research and Development, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, U.S.A
    2. Department of Health Services, University of Washington, Seattle, Washington, U.S.A
    3. Department of Epidemiology, University of Washington, Seattle, Washington, U.S.A
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  • Albert L. Merati MD,

    1. Department of Otolaryngology–Head and Neck Surgery , University of Washington, Seattle, Washington, U.S.A
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  • Bevan Yueh MD, MPH

    1. Department of Otolaryngology–Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, U.S.A
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  • This study was supported in part by the U.S. Department of Veterans Affairs Northwest Center of Excellence for Health Services Research and Development and by an American Academy of Otolaryngology–Head and Neck Surgery Resident Research C.O.R.E. grant.

  • The authors have no other funding, financial relationships, or conflicts of interest to disclose.

  • §

    Views expressed in this article are those of the authors and do not necessarily represent the view of the U.S. Department of Veterans Affairs or the University of Washington.

Abstract

Objectives/Hypothesis:

The relationship between gastroesophageal reflux disease (GERD) and laryngeal cancer has not been fully elucidated. This case-control study investigates whether GERD increases the odds of developing these malignancies.

Study Design:

Case-control study.

Methods:

Rates of GERD among cases of laryngeal cancer identified in the Veterans Health Administration outpatient care files (year 2000–2006) were compared with controls. Cases (N = 14,449) were frequency matched 1:1 with controls. Multivariate logistic regression was used to determine the association between GERD and cancer.

Results:

After adjusting for tobacco and/or alcohol use, there was no association between GERD and laryngeal cancer (adjusted odds ratio, 1.01; 95% confidence interval, 0.92-1.12, P =.780). Although an association was found when time from GERD diagnosis to malignancy was less than 3 months, it disappeared when this period was extended further.

Conclusions:

In this population, there was no increased risk of laryngeal cancer among patients with GERD. However, in subsite analysis, a possible relationship between GERD and glottic cancer was observed. Reverse causality must be considered in future studies assessing the relationship between reflux and laryngeal cancer to limit misclassification bias. Laryngoscope, 2011

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