Symptomatic Gastroesophageal Reflux as a Risk Factor for Esophageal Adenocarcinoma

The incidence of adenocarcinomas of the esophagus and gastric cardia has risen rapidly in the United States and western Europe, including Sweden, in recent decades. 1 – 4 The increase has been more pronounced for adenocarcinoma of the esophagus than for adenocarcinoma of the gastric cardia. 1 – 5 Only a few, moderately strong, risk factors have been identified, and the reasons for the rising incidence are unknown. 6 There are reasons to suspect that gastroesophageal reflux plays an important part in the development of esophageal adenocarcinoma. Chronic reflux is the main cause of Barrett's esophagus, 7 a columnar-cell metaplasia that replaces the native squamous-cell epithelium . . .