Acid reflux and head and neck cancer risk: A nationwide registry over 13 years

Kuo, Chin Lung; Chen, Yung Tai; Shiao, An Suey; Lien, Chiang Feng; Wang, Shuu Jiun

doi:10.1016/j.anl.2015.03.008

Cited by 21 publications

(18 citation statements)

References 33 publications

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“…More specifically, reflux of gastric acid is known to affect the larynx and cause laryngopharyngeal reflux . A large cohort study found that, when compared to the general population, GERD patients had greater incidence of oropharyngeal and hypopharyngeal cancers . Additionally, cell‐line studies have shown that gastric acid is carcinogenic for both laryngeal and hypopharyngeal cells .…”

Section: Introductionmentioning

confidence: 99%

“…7 A large cohort study found that, when compared to the general population, GERD patients had greater incidence of oropharyngeal and hypopharyngeal cancers. 8 Additionally, cell-line studies have shown that gastric acid is carcinogenic for both laryngeal 9 and hypopharyngeal cells. 9,10 Unlike the esophagus, the larynx lacks protective mechanisms against acid such as mucus, peristalsis, and carbonic anhydrase enzyme.…”

Section: Introductionmentioning

confidence: 99%

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Gastroesophageal reflux disease and odds of head and neck squamous cell carcinoma in North Carolina

2015

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Gastroesophageal reflux disease and odds of head and neck squamous cell carcinoma in North Carolina

2015

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“…Nevertheless, establishing a relationship between a benign disorder (i.e., acid reflux disorders) and a malignant disease (i.e., oropharyngeal, hypopharyngeal, or laryngeal cancers) still has a certain influence on clinical practice [11][12][13][14]. Clinicians need to remain vigilant with patients with acid reflux disorders and rule out the possibility and presence of head and neck cancer although co-existence does not necessarily mean that a causal relationship ex-…”

Section: Acid Reflux Increases Susceptibility To Laryngopharyngeal Anmentioning

confidence: 99%

“…Hence, the author used the National Health Insurance (NHI) database in Taiwan to analyze the medical information from a million individuals from 1998 to 2010. From the data, the author found nearly 40,000 adults (39,845 adults over the age of 20) diagnosed with GERD and compared the probability of these patients contracting head and neck cancer with that of the general population using the standardized incidence ratio[12].…”

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confidence: 99%

Acid Reflux Increases Susceptibility to Laryngopharyngeal and Oropharyngeal Cancers

Kuo¹

2020

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N owadays, people's daily routines are becoming increasingly irregular, particularly when it comes to eating and drinking. For example, people need to cope with pressures at work and rely on coffee to get them through the day. Some people even drink coffee as they would water, which could lead to heartburn in the long term. As the esophagus is unable withstand gastric acid like the stomach wall can, persistent exposure to gastric acid may corrode the esophagus. Previous studies have found that longterm corrosion of the esophagus by gastric acid could result in esophageal cancer [1]. Refluxing, though, does not stop at the esophagus (Figure 1); the gastric acid continues upwards to the pharynx, larynx, oral cavity, and nasal cavity, which can cause certain discomfort, such as a foreign body sensation in the throat, difficulties swallowing, and hoarseness after awakening. The author has had several patients who have come to the clinic complaining about an inability to cough out phlegm in their throat, no matter what they do. For some relief, they constantly clear their throat, but this relief is only temporary. An otolaryngoscopic examination would show that their laryngeal mucosa has become extremely swollen due to gastric acid burn. Other patients have complained about coughing for months. Yet, chest X-rays and visits to pulmonologists would show nothing remarkable. When the author tells patients that the cause of their discomfort may be acid reflux, 6 out of 10 patients would say, "But I don't have acid reflux!" or "Doctor, you must be wrong! I just had a gastroscopy last month and the gastroenterologist said I was fine!" Indeed, otolaryngologists and gastroenterologists may differ in the management of the acid reflux related disorders [2,3]. The fact is that the patients may have laryngopharyngeal reflux (LPR) rather than gastroesophageal reflux disease (GERD). In GERD, the reflux of gastric contents is limited to the esophagus. In LPR, the reflux of gastric content affects the larynx and pharynx. Despite occasional cross-diagnoses of GERD and LPR, there are essential differences. GERD is accompanied by acidity and heartburn (retrosternal burning), which is rarely encountered in LPR patients. In GERD, reflux and acidity typically occur during the night (nocturnal refluxers). In LPR, reflux typically occurs during the day (daytime refluxers). LPR symptoms occur when patients are in an upright position during periods of physical exertion (e.g., bending over, Valsalva, and exercise), whereas GERD reflux occurs while patients are lying down [4].

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“…This condition has also been linked to asthma, bronchitis, chronic rhinitis, sinusitis, and otitis media. Researchers have reported potential associations between acid reflux and esophageal, oropharyngeal, and hypopharyngeal neoplasms [62].…”

Section: Behavior Modificationsmentioning

confidence: 99%

Laryngopharyngeal Reflux: An Update

Kuo¹

2019

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Laryngopharyngeal reflux (LPR), also referred to as extra-esophageal reflux, supra-esophageal reflux, or silent reflux, refers to a condition in which gastroduodenal content rises up the esophagus and affects the throat, specifically the laryngopharynx [1-6]. In some cases, gastric content may even reach the nasal cavities and/or ears via the Eustachian tubes, which can exacerbate rhinitis, sinusitis, or otitis media [7-9]. Otolaryngologists and gastroenterologists differ in their definitions and management of LPR [4,10-12]. Otolaryngologists treat LPR as a relatively new clinical entity, whereas gastroenterologists treat LPR as a rare extra-esophageal manifestation of gastroesophageal reflux disease (GERD) [10,13]. Gastroenterologists have questioned whether reflux contributes to LPR-related symptoms in patients with no GERD-associated manifestations [11]. Otolaryngologists have pointed out that LPR is a multifactorial syndrome that also involves gaseous and/or nonacid refluxate [14,15]. In this article, we examine the clinical manifestations, diagnosis, and current recommended treatments of LPR. Based on the latest findings in LPR research, we propose an algorithm aimed at facilitating the assessment and management of LPR. Differences Between LPR and GERD Despite similarities between LPR and GERD, these are two distinct disease entities. The retrograde flow of gastroduodenal contents into the esophagus and/or adjacent structures can lead to complications or troublesome reflux-associated symptoms, such as throat clearing, heartburn, and globus pharyngeus. Reflux diseases can be categorized as LPR, erosive esophagitis, and nonerosive reflux disease (NERD). Cases of erosive esophagitis and NERD are categorized as GERD [16]. In GERD, the reflux of gastric contents is limited to the esophagus. In LPR, the reflux of gastric content affects the larynx and pharynx [12]. Despite occasional cross-diagnoses of GERD and LPR, there are essential differences (Table 1). GERD is accompanied by acidity and heartburn (retrosternal burning), which is rarely encountered in LPR patients [12]. In GERD, reflux and acidity typically occur during the night (nocturnal refluxers). In LPR, reflux typically occurs during the day (daytime refluxers) [12]. LPR symptoms occur when patients are in an upright position during periods of physical exertion (e.g., bending over, Valsalva, and exercise) [11,12,17], whereas GERD reflux occurs while patients are lying down.

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Acid reflux and head and neck cancer risk: A nationwide registry over 13 years

Cited by 21 publications

References 33 publications

Gastroesophageal reflux disease and odds of head and neck squamous cell carcinoma in North Carolina

Gastroesophageal reflux disease and odds of head and neck squamous cell carcinoma in North Carolina

Acid Reflux Increases Susceptibility to Laryngopharyngeal and Oropharyngeal Cancers

Laryngopharyngeal Reflux: An Update

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