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Gastroenterology and hepatology
Cohort profile
Cohort profile: the Nordic Antireflux Surgery Cohort (NordASCo)
  1. John Maret-Ouda1,
  2. Karl Wahlin1,
  3. Miia Artama2,
  4. Nele Brusselaers3,4,
  5. Martti Färkkilä5,
  6. Elsebeth Lynge6,
  7. Fredrik Mattsson1,
  8. Eero Pukkala7,8,
  9. Pål Romundstad9,
  10. Laufey Tryggvadóttir10,11,
  11. My von Euler-Chelpin6,
  12. Jesper Lagergren1,12
  1. 1Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
  2. 2Impact Assessment Unit, Department of Health Protection, National Institute for Health and Welfare, Tampere, Finland
  3. 3Centre for Translational Microbiome Research CTMR, Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
  4. 4Science For Life Laboratory (SciLifeLab), Karolinska Institutet, Stockholm, Sweden
  5. 5Clinic of Gastroenterology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
  6. 6Department of Public Health, University of Copenhagen, Copenhagen, Denmark
  7. 7Institute for Statistical and Epidemiological Cancer Research, Finnish Cancer Registry, Helsinki, Finland
  8. 8School of Health Sciences, University of Tampere, Tampere, Finland
  9. 9Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
  10. 10Icelandic Cancer Registry, Icelandic Cancer Society, Reykjavik, Iceland
  11. 11Faculty of Medicine, University of Iceland, Reykjavik, Iceland
  12. 12Division of Cancer Studies, King’s College London, London, UK
  1. Correspondence to Dr John Maret-Ouda; john.maret.ouda{at}ki.se

Abstract

Purpose To describe a newly created all-Nordic cohort of patients with gastro-oesophageal reflux disease (GORD), entitled the Nordic Antireflux Surgery Cohort (NordASCo), which will be used to compare participants having undergone antireflux surgery with those who have not regarding risk of cancers, other diseases and mortality.

Participants Included were individuals with a GORD diagnosis recorded in any of the nationwide patient registries in the Nordic countries (Denmark, Finland, Iceland, Norway and Sweden) in 1964–2014 (with various start and end years in different countries). Data regarding cancer, other diseases and mortality were retrieved from the nationwide registries for cancer, patients and causes of death, respectively.

Findings to date The NordASCo includes 945 153 individuals with a diagnosis of GORD. Of these, 48 433 (5.1%) have undergone primary antireflux surgery. Median age at primary antireflux surgery ranged from 47 to 52 years in the different countries. The coding practices of GORD seem to have differed between the Nordic countries.

Future plans The NordASCo will initially be used to analyse the risk of developing known or potential GORD-related cancers, that is, tumours of the oesophagus, stomach, larynx, pharynx and lung, and to evaluate the mortality in the short-term and long-term perspectives. Additionally, the cohort will be used to evaluate the risk of non-malignant respiratory conditions that might be caused by aspiration of gastric contents.

  • fundoplication
  • gastro-oesophageal reflux disease
  • oesophagus
  • laparoscopic surgery.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2017-016505

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    Footnotes

    • Contributors JMO, MA, NB, MF, EL, EP, PR, LT, MvEC and JL handled the permissions and data collection within each country. JMO, KW, FM, MvEC and JL handled the data management, merging of the data sets and analyses. JMO drafted the manuscript. JMO, KW, MA, NB, MF, EL, FM, EP, PR, LT, MvEC and JL revised the manuscript for important intellectual content. JL was responsible for the final version of the manuscript.

    • Funding This work was supported by the Swedish Research Council [D0547801], the Swedish Cancer Society [2015/460] and the Nordic Cancer Union [186058]. The grant providers had no role in the design, conduction, analysis or reporting of the cohort.

    • Competing interests None declared.

    • Ethics approval Ethical committees in Iceland, Norway and Sweden (permissions VSN-14-083, 2014/1498-3, 2014/234-31 and 2015/240-32, respectively). The Data Protection Authorities of Denmark and Iceland (permissions 2014-41-3503 and 2014050845, respectively), and in Finland from the National Institute for Health and Welfare, Statistics Finland and the Population Register Centre (permissions THL/1404/5.05.00/2014, TK53-1555-15 and 2345/410/15).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Due to strict data management regulations in Denmark, the data are stored on servers within Statistics Denmark. The data cannot be accessed by potential new collaborators without permission from the original data holders in each of the countries, and access to the data at Statistics Denmark is restricted.

    • Collaborators We invite researchers with interests related to the diseases included in the NordASCo to contact the research group for discussion regarding collaborative research. Researchers interested in collaborating in exploring the cohort data are welcome to contact Professor Lagergren, Chief Investigator of the NordASCo.