INTRODUCTION : Squamous cell carcinoma of the
oesophagus is a common cancer among South Africans.
Due to the absence of effective screening and surveillance
programme for early detection and late presentation,
squamous cell carcinoma of the oesophagus is usually
diagnosed at an advanced stage or when metastasis has
already occurred. The 5-year survival is often quoted at
5%–10%, which is poor.
OBJECTIVES : To determine the association between
oesophageal squamous cell carcinoma (OSCC) and non-acid
gastro-oesophageal reflux disease.
METHODS : A cross-sectional case–control analytical study
of patients referred to the Gastroenterology Division of
Steve Biko Academic Hospital in Pretoria, South Africa.
All patients had combined multichannel impedance and
pH studies done and interpreted after upper gastroscopy
using the American College of Gastroenterology guidelines
by two clinicians.
RESULTS : Thirty-two patients with OSCC were recruited:
non-acid reflux was found in 23 patients (73%), acid
reflux in 2 patients (6%) and 7 patients (22%) had normal
multichannel impedance and pH studies. Forty-nine
patients matched by age, gender and race were recruited
as a control group. Non-acid reflux was found in 11 patients (22%), acid reflux in 31 patients (63%) and 7
patients (14%) had normal multichannel impedance and
pH monitoring study.
CONCLUSION : The significance of the association between
non-acid reflux and OSCC was tested using χ2, and simple
logistic regression was used to adjust for the effects of
potential confounders. The OR of developing OSCC in
patients with non-acid gastro-oesophageal reflux was
8.8 (95% CI 3.2 to 24.5, P<0.0001) in this South African
group. Alcohol and smoking had no effect on these