Barrett's Oesophagus
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Wayne66
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Quote Wayne66 Replybullet Topic: Asprin research
    Posted: 01 Nov 2017 at 4:07pm
I've just read a newspaper article about taking Aspirin.http://www.telegraph.co.uk/science/2017/10/30/aspirin-day-keeps-many-cancers-away-study-suggests/

Also,just to add to the fog that surrounds our condition this has also popped up. http://www.dailymail.co.uk/news/article-5037371/Acid-reflux-pills-raise-risk-cancer-eight-fold.html


The more I'm learning about Barretts,mainly from this great site by the way,the more anxious I'm becoming!

Worried Wayne

Edited by Wayne66 - 02 Nov 2017 at 4:04pm
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chrisrob
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Quote chrisrob Replybullet Posted: 01 Nov 2017 at 5:22pm
Hi Wayne,

Welcome to the forum.

Firstly oesophageal cancer is something to be aware of but not to freak you out.
Barrett's oesophagus is a protective construct to protect the body from acid erosion. As such, it can be considered a friend. However, keep throwing acid on him and he may change.

The risk of progression is, however, very small. There may be 3 million of us with Barrett's but fewer than 8,000 die each year due to adenocarcinoma. (See this chapter in the Down with Acid book.)

The chemo-protective effect of aspirin has been noted in other cancers for years. Whether it is a useful adjunct in reducing risk of oesophageal adenocacinoma is debatable since aspirin itself irritates the gastric lining resulting in increased acid production. The AspECT trial (Aspirin and Esomeprazole Chemoprevention Trial) has been running for over 9 years and hopes to report next year but initial findings are not that encouraging.

On the other hand, PPIs themselves may be chemo-protective with a meta-analysis, Acid-suppressive medications and risk of oesophageal adenocarcinoma in patients with Barrett’s oesophagus: a systematic review and meta-analysis showing a probable reduction in risk of 71%.

The study regarding PPIs and increased risk of stomach cancers, Maintenance therapy with proton pump inhibitors and risk of gastric cancer: a nationwide population-based cohort study in Sweden, published on Monday has been pounced upon by the sensationalist press who love a horror story.

Compare these newspapers:
Daily Mail: "Over-the-counter and prescription acid reflux pills taken by millions 'raise the risk of stomach cancer by up to eight-fold' if they are used regularly"

Daily Express: "Stomach cancer warning: Taking long-term acid reflux medication could DOUBLE your risk"

The Guardian: "Acid reflux drug linked to more than doubled risk of stomach cancer" which did append: Responding to the study, Stephen Evans, professor of pharmacoepidemiology at the London School of Hygiene and Tropical Medicine, said: “Many observational studies have found adverse effects associated with PPIs.
“The most plausible explanation for the totality of evidence on this is that those who are given PPIs, and especially those who continue on them long-term, tend to be sicker in a variety of ways than those for whom they are not prescribed.”

It is always best, if possible to find the original study. Not always easy as the papers don't usually link it but usually found on the Barrett's Wessex News / Research page. It said, ""Of all 5823 patients with gastric cancer diagnosed during the study period, 38.1% occurred among maintenance PPI users."

I recommend anyone alarmed by newspaper reporting to read the facts here.
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steveb8189
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Quote steveb8189 Replybullet Posted: 02 Nov 2017 at 9:02am
Hi Chris

I did have a read of the paper on PPIs linkage to stomach cancer and the headlines, whilst a little sensationalist, do seem to reflect accurately the findings of the paper. It studied a decent number of people taking PPIs after treatment for h pylori infection. The actual numbers are still very small and whilst the risk may increase eight fold the overall chance of getting stomach cancer is still very small.
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