Despite consistent reports of an inverse association between NSAIDs and esophageal adenocarcinoma, a large population-based case–control cohort study has found little support for an inverse association between NSAIDs and Barrett esophagus. Information on intake of aspirin and non-aspirin NSAIDs was collected over a 5-year period in patients with non-dysplastic Barrett esophagus, patients with dysplastic Barrett esophagus, 'inflammation' controls and population controls. Whether NSAIDs prevent the onset of Barrett esophagus is a question that the authors say remains open.