Risk of adenocarcinomas of the oesophagus and gastric cardia in patients hospitalized for asthma

In the first cohort study of the question we followed 92 986 (42 663 men an d 50 323 women) adult patients hospitalized for asthma in Sweden from 1965 to 1994 for an average of 8.5 years to evaluate their risk, of oesophageal and gastric cardia adenocarcinoma. Standardized incidence ratio (SIR) adjus ted for gender, age and calendar year was used to estimate relative risk, u sing the Swedish nationwide cancer incidence rates as reference. Asthmatic patients overall had a moderately elevated risk for oesophageal adenocarcin oma (SIR = 1.5, 95% confidence interval Cl, 0.9-2.5) and gastric cardia can cer (SIR = 1.4, 95% Cl, 1.0-1.9). However, the excess risks were largely co nfined to asthmatic patients who also had a discharge record of gastro-oeso phageal reflux (SIR = 7.5, 95% Cl, 1.6-22.0 and SIR = 7.1, 95% Cl, 3.1-14.0 , respectively). No significant excess risk for oesophageal squamous-cell c arcinoma or distal stomach cancer was observed. In conclusion, asthma is as sociated with a moderately elevated risk of developing oesophageal or gastr ic cardia adenocarcinoma. Special clinical vigilance vis-a-vis gastro-esoph ageal cancers seems unwarranted in asthmatic patients, but may be appropria te in those with clinically manifest gastro-oesophageal reflux. (C) 2001 Ca ncer Research Campaign.