GERD and Upper Aerodigestive Tract Cancer Risk: A Systematic Review and Meta‐Analysis
Abstract
OBJECTIVE: Gastroesophageal reflux disease (GERD) is highly prevalent, yet its association with upper aerodigestive tract (UADT) cancers beyond esophageal adenocarcinoma remains incompletely defined. This systematic review and meta-analysis aimed to quantify the risk of specific UADT cancers in individuals with GERD. DATA SOURCES: A comprehensive search of PubMed, Embase, Scopus, the Cochrane Library, and CINAHL was conducted for studies published from January 2000 to October 2024. REVIEW METHODS: Observational studies (cohort or case-control) evaluating GERD as a risk factor for UADT cancers in adults were included, following PRISMA guidelines (PROSPERO: CRD42024602545). Esophageal adenocarcinoma was excluded due to its well-established association with GERD. Study quality was assessed using the Newcastle-Ottawa scale. Pooled relative risks (RR) and 95% confidence intervals (CI) were calculated using random effects models. RESULTS: Seventeen studies (12 case-control, 5 cohort), encompassing 1,768,394 participants, met inclusion criteria. GERD was significantly associated with laryngeal cancer (RR = 1.65, 95% CI = 1.19-2.31). No significant associations were found for pharyngeal, oropharyngeal, hypopharyngeal, or esophageal squamous cell carcinoma. Subgroup analysis showed stronger associations in U.S.-based studies (RR = 1.61) and in studies using ICD-coded GERD (RR = 1.93). CONCLUSION: GERD is associated with an increased risk of laryngeal cancer. Findings support further…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,768,394 participants or records.
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