Non-erosive reflux disease and oesophageal carcinoma

Gastroesophageal reflux disease is a pervasive health concern, affecting a substantial proportion of the global population. Prevalence ranges from 10% to 20% in North America and Europe, and around 5% in Asian countries.1 The conventional diagnostic approach involves endoscopic assessment of oesophageal mucosa, particularly in cases where patients report high risk symptoms (ie,dysphagia, bleeding, vomiting, and anaemia) or did not respond to proton pump inhibitor treatment.2 The established association between gastroesophageal reflux disease with erosive oesophagitis and mucosal abnormalities and an increased risk of oesophageal adenocarcinoma is widely acknowledged. However, a substantial proportion (60-70%)2 of patients with gastroesophageal reflux disease have non-erosive reflux disease, with no signs of erosion on endoscopy. Their risk of oesophageal adenocarcinoma remains relatively unexplored.

In a linked article,3 Holmberg and colleagues help to fill this knowledge gap with a comprehensive, population based cohort study (doi:10.1136/bmj-2023-076017) comparing risk of oesophageal adenocarcinoma in patients with either non-erosive or erosive reflux disease with the general population. This study included nearly …