No EoE-Esophageal Cancer Link Found in Large US Study

TOPLINE:

Eosinophilic esophagitis (EoE) is not associated with the development of esophageal cancer in privately insured US adults younger than 65 years.

METHODOLOGY:

• Because chronic inflammation is associated with several cancers, but some studies suggest that allergic inflammation, like that of EoE, might offer a protective benefit, researchers examined whether EoE is linked with esophageal cancer.
• For their case-control study, researchers analyzed 2009-2022 data on 5562 commercially insured patients aged 18-64 years (median age, 58.8 years) with esophageal cancer. Patients were matched to 55,620 control individuals without the condition by age and amount of time in the health plan.
• All participants were required to have at least 2 years of continuous healthcare coverage before the index date, defined as the date of the earliest esophageal cancer claim.
• Patients whose first EoE claim date occurred before their esophageal cancer claim date were classified as patients with EoE in this study.

TAKEAWAY:

• A higher proportion of patients with esophageal cancer than controls had symptoms or diagnoses associated with esophageal cancer or EoE, such as Barrett’s esophagus, heartburn, dysphagia, and abnormal weight loss.
• However, a smaller proportion of patients with esophageal cancer than controls experienced allergic diseases.
• A history of EoE was rare in both participants with and without esophageal cancer. Only two patients with cancer (0.04%) and 44 control individuals (0.08%) had a prior diagnosis of EoE (odds ratio, 0.46).

IN PRACTICE:

“These results can reassure EoE patients and add to the literature examining the relationship between chronic allergic inflammation and carcinogenesis. Further studies should assess whether these findings hold in those above 65, with public insurance, and in each [esophageal cancer] subtype, and assess for potential differences in EoE severity and treatment history — or whether EoE is in fact protective against [esophageal cancer],” the authors wrote.

SOURCE:

The study, led by Natasha Albaneze, Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, was published online in Alimentary Pharmacology & Therapeutics.

LIMITATIONS:

Study limitations include the inability to include patients over age 64, which is the population in which esophageal cancer is most prevalent; the relatively brief duration of patient enrollment in health plans; and the inability to stratify outcomes by esophageal cancer subtypes or EoE severity and treatment history.

DISCLOSURES:

This study received support from the National Institutes of Health. The authors declared no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.