Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • News & Views
  • Published:

GASTROINTESTINAL CANCER

Chemoprevention of Barrett’s oesophagus: a step closer with PPIs and aspirin

Chemoprevention for patients with Barrett’s oesophagus remains a controversial topic. Results of the first randomized trial of chemoprevention using a proton pump inhibitor with or without aspirin were recently reported. We highlight strengths and weaknesses in the design of the trial and discuss the clinical implications of the findings.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

References

  1. Jankowski, J. A. et al. Esomeprazole and aspirin in Barrett’s oesophagus (AspECT): a randomized factorial trial. Lancet 392, 400–408 (2018).

    Article  CAS  Google Scholar 

  2. Singh, S. et al. Acid-suppressive medications and risk of oesophageal adenocarcinoma in patients with Barrett’s oesophagus: a systematic review and meta-analysis. Gut 63, 156–163 (2014).

    Article  Google Scholar 

  3. Liao, L. M. et al. Nonsteroidal anti-inflammatory drug use reduces risk of adenocarcinomas of the esophagus and esophagogastric junction in a pooled analysis. Gastroenterology 142, 442–445 (2012).

    Article  CAS  Google Scholar 

  4. Porta, N., Bonet, C. & Cobo, E. Discordance between reported intention-to-treat and per protocol analyses. J. Clin. Epidemiol. 60, 663–669 (2007).

    Article  Google Scholar 

  5. Shaheen, N. J. et al. ACG clinical guideline: diagnosis and management of Barrett’s esophagus. Am. J. Gastroenterol. 111, 30–50 (2016).

    Article  CAS  Google Scholar 

  6. Fitzgerald, R. C. et al. British Society of Gastroenterology guidelines on the diagnosis and management of Barrett’s oesophagus. Gut 63, 7–42 (2014).

    Article  Google Scholar 

  7. Lazaras, B. et al. Proton pump inhibitor use and the risk of chronic kidney disease. JAMA Intern. Med 176, 238–246 (2016).

    Article  Google Scholar 

  8. Xie, Y. et al. Proton pump inhibitors and risk of incident CKD and progression to ESRD. J. Am. Soc. Nephrol. 27, 1–11 (2016).

    Article  Google Scholar 

  9. Haenisch, B. et al. Risk of dementia in elderly patients with the use of proton pump inhibitors. Eur. Arch. Psychiatry Clin. Neurosci. 265, 419–428 (2015).

    Article  Google Scholar 

  10. Gomm, W. et al. Association of proton pump inhibitors with risk of dementia: a pharmoepidemiological claims data analysis. JAMA Neurol. 73, 410–416 (2016).

    Article  Google Scholar 

  11. Freedberg, D. E., Kim, L. S. & Yang, Y. X. The risks and benefits of long-term use of proton pump inhibitors: expert review and best practice advice from the American Gastroenterological Association. Gastroenterology 152, 706–715 (2017).

    Article  CAS  Google Scholar 

Download references

Acknowledgements

The work of the authors is also supported in part by the NIH National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Center for Gastrointestinal Development, Infection, and Injury (grant P30DK56338).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Hashem B. El-Serag.

Ethics declarations

Competing interests

The authors declare no competing interests.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Husain, N.S., El-Serag, H.B. Chemoprevention of Barrett’s oesophagus: a step closer with PPIs and aspirin. Nat Rev Clin Oncol 15, 728–730 (2018). https://doi.org/10.1038/s41571-018-0096-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41571-018-0096-x

Search

Quick links

Nature Briefing: Cancer

Sign up for the Nature Briefing: Cancer newsletter — what matters in cancer research, free to your inbox weekly.

Get what matters in cancer research, free to your inbox weekly. Sign up for Nature Briefing: Cancer