Patients with Esophageal Adenocarcinoma with prior GERD symptoms are similar to those without GERD: A Cross-sectional Study

Objectives: A substantial proportion of esophageal adenocarcinoma (EAC) patients do not report GERD symptoms. This study aimed to compare the risk factor profiles and cancer stage at presentation of EAC patients with and without prior GERD. Methods: In this retrospective, cross-sectional study, EAC patients were divided into two cohorts: 1. EAC with prior GERD: patients who reported typical GERD symptoms (heartburn or regurgitation) ≥1 year before cancer diagnosis, and 2. EAC without prior GERD: patients who did not report prior GERD symptoms or reported symptoms within 1 year of their cancer diagnosis. Baseline demographics, risk factors, and cancer stage at presentation were compared between the two cohorts. Additionally, the distribution of patients based on numbers of BE/EAC–associated risk factors (1, 2, 3, 4, 5 or more) was examined in the symptomatic and asymptomatic cohorts. Results: Over 13 years, 388 EAC patients with prior GERD and 245 EAC patients without prior GERD were recruited. Both groups had similar baseline demographics and risk factors, but EAC patients with prior GERD were more likely to have a history of BE. Asymptomatic patients had more advanced disease. Patients with 3 or more BE/EAC related risk factors formed the largest proportion of patients in both the symptomatic and asymptomatic cohorts. Conclusions: Esophageal adenocarcinoma patients with and without prior GERD symptoms are phenotypically similar, suggesting that BE screening efforts to prevent or detect early EAC should not be restricted to just those with GERD.