Gastroesophageal reflux disease and risk of cancer: Findings from the Korean National Health Screening Cohort

Sep 24, 2026

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Little is known about how gastroesophageal reflux disease (GERD) relates to cancers beyond esophageal adenocarcinoma. This cohort study used National Health Screening Cohort data to evaluate cancer risk across types, following 10,261 GERD patients and 30,783 matched non-GERD individuals. Using Cox models adjusted for major lifestyle, demographic, and comorbidity factors, results showed higher risks for esophageal, laryngeal, and thyroid cancers, while colorectal, liver, and pancreatic cancers showed reduced risk, with implications for monitoring and early detection.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages11

Reading Time28 min

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Abstract

Introduction

Methods

Results

Conclusion

DOI: 10. 1002/cam4 .6500 RESEAR CH ARTICLE Gastroesophageal reflux disease and risk of cancer: Findings from the Korean National Health Screening Cohort Chi Lan Tran1 | Minji Han1,2,3 | Byungmi Kim2 | Eun Young Park4 | Young Il Kim5 | Jin-Kyoung Oh1,2 1Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea 2Division of Cancer Prevention, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea 3Department of Health Science and Technology, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea 4Department of Preventive Medicine, Korea University College of Medicine, Seoul, Republic of Korea 5Center for Gastric Cancer, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea Correspondence Jin-Kyoung Oh, Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-769, 10408, Republic of Korea. [Email:](Email: jkoh@ncc.re.kr)[ jkoh@ncc.re.kr](Email: jkoh@ncc.re.kr) Funding information National Cancer Center, Grant/ Award Number: NCC2010303 and NCC2310652 Abstract Aim: Little is known about the association of cancers other than esophageal adenocarcinoma with gastroesophageal reflux disease (GERD). This study aimed to examine the association between GERD and the risk of different types of cancer. Methods: A cohort study was conducted using data from the National Health Screening Cohort. We included 10,261 GERD patients and 30,783 non-GERD individuals who were matched in a 1:3 ratio by age and sex. All participants were followed-up until cancer diagnosis, death, or end of the study (December 31, 2015). Hazard ratios were calculated using the Cox proportional hazards model, adjusting for smoking and alcohol consumption, physical activity, body mass index, income, area, and Charlson Comorbidity Index. Results: The median follow-up time was 9.9 years. GERD was associated with an increased risk of esophageal (adjusted hazard ratios [aHR] = 3.20 [1.89–5.41]), laryngeal (aHR = 5.42 [2.68–10.96]), and thyroid cancers (aHR = 1.91 [1.55–2.34]) after controlling for all covariates. The results were consistent when examining GERD with esophagitis (K210) and without esophagitis (K219) separately. For thyroid cancer, the results were insignificant after controlling for having everreceived thyroid biopsy procedures. A dose–response relationship was found between GERD and esophageal cancer as well as laryngeal cancer, with patients with a longer duration of GERD treatment showing a stronger effect. In contrast, GERD was associated with a reduced risk of colorectal (aHR = 0.73 [0 .59–0.90]), liver (aHR = 0.67 [0.51–0.89]), and pancreatic cancers (aHR = 0.43 [0.24–0.76]), which might have resulted from differences in healthcare utilization between GERD and non-GERD groups. Conclusion: GERD was associated with an increased risk of esophageal and laryngeal cancers. Additionally, early detection and treatment of precancerous lesions among the GERD group could lead to a lower risk of colorectal, liver, and pancreatic cancers. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. © 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. KEYWORDS cancer risk, cohort, gastroesophageal reflux disease, laryngeal cancer 1 | INTRODUCTION Gastroesophageal reflux disease (GERD) is a common digestive condition caused by the backflow of stomach contents into the esophagus or oral cavity, resulting in symptoms and complications such as heartburn and regurgitation.1,2 GERD is associated with esophageal obstruction, erosive esophagitis, Barrett's esophagus, and esophageal

FAQs

What is the main research question of the study?

The study examines the association between gastroesophageal reflux disease (GERD) and the risk of different types of cancer, not limited to esophageal adenocarcinoma.

How were participants selected and followed in the cohort study?

The analysis included 10,261 GERD patients and 30,783 non-GERD individuals matched 1:3 by age and sex, followed until cancer diagnosis, death, or December 31, 2015.

Which cancers showed increased or decreased risk in relation to GERD?

GERD was associated with increased risk of esophageal, laryngeal, and thyroid cancers, while colorectal, liver, and pancreatic cancers showed reduced risk after adjustment.

Sep 24, 2026

Uploaded by McQueen