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Relationship Between Diabetes Mellitus and Adenocarcinoma of the Esophagus and Gastric Cardia

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Rubenstein, Joel H., M.D.; Davis, Jennifer, M.H.S.A.; Marrero, Jorge A., M.D.; Inadomi, John M., M.D.

American Journal of Gastroenterology: September 2005 - Volume 100 - Issue - p S23
Supplement Abstracts Submitted for the 70th Annual Scientific Meeting of the American College of Gastroenterology: ESOPHAGUS
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Division of Gastroenterology, University of Michigan Medical School, Ann Arbor, MI; Ann Arbor Veterans Affairs Medical Center, Ann Arbor, MI and VA Center for Practice Management and Outcomes Research, Ann Arbor Veterans Affairs Medical Center, Ann Arbor, MI.

Purpose: Obesity is a risk factor for adenocarcinomas of the esophagus and gastric cardia. Diabetes mellitus might mediate that association. This is the largest study to date to evaluate the association. We aimed to estimate the risk of diabetes mellitus on the development of adenocarcinoma of distal esophagus and gastric cardia beyond that of gastroesophageal reflux disease.

Methods: A case-control study was performed using a national administrative database of the Veterans Administration.

Results: 311 cases of cancer and 10,154 controls were identified. Gender, age, and race were risks for cancer. Diabetes was diagnosed in 36% of cases, and 32% of controls (p = 0.15). Diabetic complications were diagnosed in 14% of cases and 13% of controls (p = 0.60). Multiple logistic regression confirmed the absence of an association between cancer and diabetes (odds ratio 1.1, 95% confidence interval 0.8 – 1.5) or diabetic complications (odds ratio 0.8, 95% confidence interval 0.6 – 1.3).

Conclusions: Within the limitations of this case-control study, there is no evidence of an association between diabetes and adenocarcinoma of the esophagus or gastric cardia among U.S. veterans with gastroesophageal reflux disease.

© The American College of Gastroenterology 2005. All Rights Reserved.