Gastroenterol Res

Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access

Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc

Journal website https://www.gastrores.org

Original Article

Volume 15, Number 4, August 2022, pages 173-179

The Association Between Gastroesophageal Reflux Disease and Non-Small Cell Lung Cancer: A Retrospective Case-Control Study

Figure 1. Pie chart depicting histological subtypes amongst 543 patients diagnosed with NSCLC: 93% of the patients had adenocarcinoma, 6% had squamous cell carcinoma and 1% had large cell carcinoma. NSCLC: non-small cell lung cancer.

Figure 2. Forest plot of odds ratio (OR) values (x-axis) according to the independent risk predictors (y-axis) of non-small cell lung cancer. COPD: chronic obstructive pulmonary disease; GERD: gastroesophageal reflux disease; PPI: proton pump inhibitors; OR: odds ratio; CI: confidence interval.

**Table 1.** Baseline Demographic Characteristics of Patients With Non-Small Cell Lung Cancer (NSCLC) and Controls
Variables	NSCLC, n = 543	Controls, n = 540	P value
SD: standard deviation.
Age (years), mean ± SD	72.9 ± 13.1	71.7 ± 10.7	0.091
Sex, n (%)			0.676
Female	407 (74.9)	398 (73.7)
Male	136 (25)	142 (26.3)
Ethnicity, n (%)			< 0.001
White	360 (66.4)	402 (74.5)
Black	46 (8.4)	61 (11.2)
Other	137 (25.2)	77 (14.3)
Weight kg/m², n (%)			0.058
Basic metabolic index < 30	420 (77.4)	390 (72.2)
Basic metabolic index > 30	123 (22.6)	150 (27.8)
Alcohol use, n (%)			< 0.001
History of use	161 (29.7)	104 (19.2)
No use	382 (70.3)	436 (80.8)
Medical history, n (%)
Gastroesophageal reflux disease	111 (20.4)	63 (11.6)	< 0.001
Congestive heart failure	26 (4.8)	13 (2.4)	0.840
Chronic kidney disease	13 (2.4)	6 (1.1)	0.116
Liver cirrhosis	2 (0.3)	1 (0.2)	1.000
Asthma	26 (4.7)	13 (2.4)	0.052
Chronic obstructive pulmonary disease	26 (4.8)	7 (1.3)	< 0.01
Hypertension	157 (28.9)	241 (44.6)	< 0.01
Dyslipidemia	117 (21.5)	177 (32.9)	< 0.01
Atrial fibrillation	26 (4.7)	29 (5.3)	0.681
Family history of lung cancer	114 (21)	87 (16)	0.023
Medications, n (%)
Antihistamine	28 (5)	34 (6.3)	0.299
Proton pump inhibitor	108 (19.8)	78 (14.4)	0.017
Non-steroid anti-inflammatory drugs	92 (16.9)	109 (20.2)	0.166
Prednisone	40 (7.3)	22 (4)	0.028
Anticholinergic	40 (7.3)	25 (4.6)	0.077
Nitrates	8 (1.4)	2 (0.4)	0.109
Calcium channel blockers	92 (17)	77 (14.2)	0.189
Opioids	56 (10.2)	29 (5.3)	< 0.01
Benzodiazepines	45 (7.8)	36 (6.6)	0.490

Table 1. Baseline Demographic Characteristics of Patients With Non-Small Cell Lung Cancer (NSCLC) and Controls

Variables

NSCLC, n = 543

Controls, n = 540

P value

SD: standard deviation.

Age (years), mean ± SD

72.9 ± 13.1

71.7 ± 10.7

0.091

Sex, n (%)

0.676

Female

407 (74.9)

398 (73.7)

Male

136 (25)

142 (26.3)

Ethnicity, n (%)

< 0.001

White

360 (66.4)

402 (74.5)

Black

46 (8.4)

61 (11.2)

Other

137 (25.2)

77 (14.3)

Weight kg/m², n (%)

0.058

Basic metabolic index < 30

420 (77.4)

390 (72.2)

Basic metabolic index > 30

123 (22.6)

150 (27.8)

Alcohol use, n (%)

< 0.001

History of use

161 (29.7)

104 (19.2)

No use

382 (70.3)

436 (80.8)

Medical history, n (%)

Gastroesophageal reflux disease

111 (20.4)

63 (11.6)

< 0.001

Congestive heart failure

26 (4.8)

13 (2.4)

0.840

Chronic kidney disease

13 (2.4)

6 (1.1)

0.116

Liver cirrhosis

2 (0.3)

1 (0.2)

1.000

Asthma

26 (4.7)

13 (2.4)

0.052

Chronic obstructive pulmonary disease

26 (4.8)

7 (1.3)

< 0.01

Hypertension

157 (28.9)

241 (44.6)

< 0.01

Dyslipidemia

117 (21.5)

177 (32.9)

< 0.01

Atrial fibrillation

26 (4.7)

29 (5.3)

0.681

Family history of lung cancer

114 (21)

87 (16)

0.023

Medications, n (%)

Antihistamine

28 (5)

34 (6.3)

0.299

Proton pump inhibitor

108 (19.8)

78 (14.4)

0.017

Non-steroid anti-inflammatory drugs

92 (16.9)

109 (20.2)

0.166

Prednisone

40 (7.3)

22 (4)

0.028

Anticholinergic

40 (7.3)

25 (4.6)

0.077

Nitrates

8 (1.4)

2 (0.4)

0.109

Calcium channel blockers

92 (17)

77 (14.2)

0.189

Opioids

56 (10.2)

29 (5.3)

< 0.01

Benzodiazepines

45 (7.8)

36 (6.6)

0.490

**Table 2.** Multivariate Analysis of Variables Associated Between GERD and NSCLC
Multivariate analysis	Adjusted OR	P value	95% CI
^aEthnicity (others) includes Asians, American Indian, Native Hawaiian, Hispanic, Alaskan Native, and other Pacific Islander. OR: odds ratio; CI: confidence interval; GERD: gastroesophageal reflux disease; NSCLC: non-small cell lung cancer; F: female; M: male; BMI: body mass index; OR: odds ratio; CI: confidence interval.
Age (< 55 vs. > 55)	0.87	0.64	(0.49 - 1.54)
Gender (F vs. M)	1.25	0.19	(0.89 - 1.73)
Weight (BMI < 30 vs. > 30)	0.94	0.73	(0.66 - 1.33)
Alcohol (no vs. yes)	0.49	< 0.01	(0.34 - 0.70)
Ethnicity (black vs. white)	0.86	0.55	(0.52 - 1.42)
Ethnicity (others^a vs. white)	2.81	< 0.01	(1.89 - 4.18)
Family history of lung cancer	0.73	0.06	(0.53 - 1.01)

Table 2. Multivariate Analysis of Variables Associated Between GERD and NSCLC

Multivariate analysis

Adjusted OR

P value

95% CI

^aEthnicity (others) includes Asians, American Indian, Native Hawaiian, Hispanic, Alaskan Native, and other Pacific Islander. OR: odds ratio; CI: confidence interval; GERD: gastroesophageal reflux disease; NSCLC: non-small cell lung cancer; F: female; M: male; BMI: body mass index; OR: odds ratio; CI: confidence interval.

Age (< 55 vs. > 55)

0.87

0.64

(0.49 - 1.54)

Gender (F vs. M)

1.25

0.19

(0.89 - 1.73)

Weight (BMI < 30 vs. > 30)

0.94

0.73

(0.66 - 1.33)

Alcohol (no vs. yes)

0.49

< 0.01

(0.34 - 0.70)

Ethnicity (black vs. white)

0.86

0.55

(0.52 - 1.42)

Ethnicity (others^a vs. white)

2.81

< 0.01

(1.89 - 4.18)

Family history of lung cancer

0.73

0.06

(0.53 - 1.01)