Back to Search
Start Over
Mortality in gastro-oesophageal reflux disease in a population-based nationwide cohort study of Swedish twins
- Source :
- BMJ Open, Vol 10, Iss 8 (2020), e037456-?, BMJ Open
- Publication Year :
- 2020
- Publisher :
- BMJ, 2020.
-
Abstract
- ObjectivesThe public health disorder gastro-oesophageal reflux disease (GORD) is linked with several comorbidities, including oesophageal adenocarcinoma (OAC), but whether life expectancy is reduced by GORD is uncertain. This study assessed all-cause and cancer-specific mortality in GORD after controlling for confounding by heredity and other factors.DesignPopulation-based cohort study from 1998 to 2015.SettingSwedish nationwide study.ParticipantsTwins (n=40 961) born in 1958 or earlier in Sweden.ExposureGORD symptoms reported in structured computer-assisted telephone interviews.OutcomesThe primary outcome was all-cause mortality and the secondary outcome was cancer-specific mortality among twins with GORD and twins without GORD. HRs and 95% CIs were analysed using parametric survival models, both in individual twin analyses and co-twin pair analyses, with adjustment for body mass index, smoking, education and comorbidity.ResultsAmong 40 961 individual twins, 5812 (14.2%) had GORD at baseline and 8062 (19.7%) died during follow-up of up to 16 years. The risks of all-cause mortality (HR=1.00, 95% CI: 0.94–1.07) and cancer-specific mortality (HR=0.99, 95% CI: 0.89–1.10) were not increased in individual twins with GORD compared with individual twins without GORD. Similarly, there were no differences in mortality outcomes in within-pair analyses. The OAC-specific mortality rate was 0.45 (95% CI: 0.32–0.66) per 1000 person-years in individual twins with GORD and 0.22 (95% CI: 0.18–0.27) per 1000 person-years without GORD, rendering an adjusted HR of 2.01 (95% CI: 1.35–2.98).ConclusionsGORD did not increase all-cause or cancer-specific mortality when taking heredity and other confounders into account. The increased relative risk of mortality in OAC was low in absolute numbers.
- Subjects :
- Pediatrics
medicine.medical_specialty
Esophageal Neoplasms
Population
Gastroenterology and Hepatology
Adenocarcinoma
Cohort Studies
Epidemiology
medicine
Humans
education
Survival analysis
Sweden
education.field_of_study
business.industry
Mortality rate
digestive, oral, and skin physiology
General Medicine
Middle Aged
medicine.disease
Comorbidity
digestive system diseases
gastrointestinal tumours
oesophageal disease
Relative risk
Gastroesophageal Reflux
Medicine
epidemiology
business
Body mass index
Cohort study
Subjects
Details
- ISSN :
- 20446055
- Volume :
- 10
- Database :
- OpenAIRE
- Journal :
- BMJ Open
- Accession number :
- edsair.doi.dedup.....a5b33e8f903e028bcaaa0ac16cbc3db6