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Oesophageal cancer and gastro-oesophageal reflux: what is the relationship?
  1. J Lagergren
  1. Correspondence to:
    Professor J Lagergren
    Department of Surgery, Karolinska University Hospital, Stockholm SE-171 76, Sweden;

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There seems to be a causal link between reflux and oesophageal adenocarcinoma, and Barrett’s oesophagus is very likely an important, and possibly necessary, link in the causal pathway from reflux to oesophageal adenocarcinoma

The direct relation between reflux and adenocarcinoma of the oesophagus has recently been addressed in several well designed population based epidemiological studies, using different study designs.1–5 The studies are all in agreement that reflux is associated with an increased risk of oesophageal adenocarcinoma in a seemingly dose dependent manner.1–5

The specific role of Barrett’s oesophagus for this association was not addressed in these studies but the presence of Barrett’s oesophagus has been regarded as a potential link in the causal pathway. More speculatively, based on an interpretation of the results from a large population based study in Sweden, we hypothesised that the relation between reflux and oesophageal adenocarcinoma might be independent of Barrett’s oesophagus.2 This hypothesis was based on two …

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