Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, Korea.
Clin Otolaryngol. 2019 Jul;44(4):534-540. doi: 10.1111/coa.13328. Epub 2019 Apr 26.
The present study evaluated the associations between gastroesophageal reflux disease (GERD) and head and neck cancer using a national sample cohort of the Korean population.
We designed two studies using data collected from patients aged ≥40 years in the Korean National Health Insurance Service-National Sample Cohort from 2002 to 2013.
Study I included participants with GERD matched 1:2 with controls and analysed the incidences of lip and oral cavity, oropharynx, hypopharynx and larynx cancers. Study II included participants with larynx cancer matched 1:4 with controls and analysed the previous histories of GERD. Head and neck cancer was identified using medical claim codes for surgical, radiation and chemotherapeutic treatments and death records from the National Statistical Office. Crude and adjusted hazard ratios (HRs) were analysed using the Cox proportional hazard model. Crude and adjusted odds ratios (ORs) were analysed using unconditional logistic regression analyses. Subgroup analyses were performed on groups stratified by age and sex.
The adjusted HR for larynx cancer was 2.32 (95% confidence interval (CI) = 1.53-3.52, P < 0.001) in the GERD group. However, the HRs for lip and oral cavity cancer, oropharynx cancer and hypopharynx cancer were not statistically significant (study I). The adjusted OR for GERD was 2.03 (95% CI = 1.40-2.96, P < 0.001) in the larynx cancer group; consistent results were obtained in subgroup analyses.
Gastroesophageal reflux disease increases the risk of larynx cancer.
本研究使用韩国全国人口的国家健康保险服务-国家抽样队列的全国样本评估胃食管反流病（GERD）与头颈部癌症之间的关联。
我们使用 2002 年至 2013 年从韩国国家健康保险服务-国家抽样队列中收集的≥40 岁患者的数据设计了两项研究。
研究 I 纳入 GERD 患者，按 1:2 与对照组匹配，并分析唇和口腔、口咽、下咽和喉癌的发病率。研究 II 纳入喉癌患者，按 1:4 与对照组匹配，并分析 GERD 的既往病史。头颈部癌症通过外科、放疗和化疗治疗的医疗索赔代码以及国家统计局的死亡记录进行识别。使用 Cox 比例风险模型分析粗和调整后的危险比（HR）。使用无条件逻辑回归分析分析粗和调整后的优势比（OR）。按年龄和性别分层进行亚组分析。
在 GERD 组中，喉癌的调整后 HR 为 2.32（95%置信区间[CI]：1.53-3.52，P<0.001）。然而，唇和口腔癌、口咽癌和下咽癌的 HR 无统计学意义（研究 I）。在喉癌组中，GERD 的调整后 OR 为 2.03（95%CI：1.40-2.96，P<0.001）；亚组分析得到了一致的结果。
胃食管反流病增加了喉癌的风险。
