BACKGROUND & AIMS: The risks of dysplasia and esophageal adenocarcinoma (EAC) are not clear for patients with nondysplastic Barrett's esophagus (NDBE); the rate of progression has been overestimated in previous studies. We studied the incidences of dysplasia and EAC and investigated factors associated with progression of BE. METHODS: The BE study is a multicenter outcomes project of a large cohort of patients with BE. Neoplasia was graded as low-grade dysplasia, high-grade dysplasia (HGD), or EAC. Patients followed up for at least 1 year after the index endoscopy examination were included, whereas those diagnosed with dysplasia and EAC within 1 year of diagnosis with BE (prevalent cases) were excluded. Of 3334 patients with BE, 1204 met the inclusion criteria (93.7% Caucasian; 88% male; mean age, 59.3 y) and were followed up for a mean of 5.52 years (6644.5 patient-years). RESULTS: Eighteen patients developed EAC (incidence, 0.27%/y; 95% confidence interval [CI], 0.17-0.43) and 32 developed HGD (incidence, 0.48%/y; 95% CI, 0.34-0.68). The incidence of HGD and EAC was 0.63%/y (95% CI, 0.47-0.86). There were 217 cases of low-grade dysplasia (incidence, 3.6%/y; 95% CI, 3.2-4.1). Five and 10 years after diagnosis, 98.6% (n = 540) and 97.1% (n = 155) of patients with NDBE were cancer free, respectively. The length of the BE was associated significantly with progression (EAC <6 cm, 0.09%/y vs EAC ≥ 6 cm, 0.65%/y; P = 0.001). CONCLUSIONS: There is a lower incidence of dysplasia and EAC among patients with NDBE than previously reported. Because most patients are cancer free after a long-term follow-up period, surveillance intervals might be lengthened, especially for patients with shorter segments of BE.
BACKGROUND & AIMS: The risks of dysplasia and esophageal adenocarcinoma (EAC) are not clear for patients with nondysplastic Barrett's esophagus (NDBE); the rate of progression has been overestimated in previous studies. We studied the incidences of dysplasia and EAC and investigated factors associated with progression of BE. METHODS: The BE study is a multicenter outcomes project of a large cohort of patients with BE. Neoplasia was graded as low-grade dysplasia, high-grade dysplasia (HGD), or EAC. Patients followed up for at least 1 year after the index endoscopy examination were included, whereas those diagnosed with dysplasia and EAC within 1 year of diagnosis with BE (prevalent cases) were excluded. Of 3334 patients with BE, 1204 met the inclusion criteria (93.7% Caucasian; 88% male; mean age, 59.3 y) and were followed up for a mean of 5.52 years (6644.5 patient-years). RESULTS: Eighteen patients developed EAC (incidence, 0.27%/y; 95% confidence interval [CI], 0.17-0.43) and 32 developed HGD (incidence, 0.48%/y; 95% CI, 0.34-0.68). The incidence of HGD and EAC was 0.63%/y (95% CI, 0.47-0.86). There were 217 cases of low-grade dysplasia (incidence, 3.6%/y; 95% CI, 3.2-4.1). Five and 10 years after diagnosis, 98.6% (n = 540) and 97.1% (n = 155) of patients with NDBE were cancer free, respectively. The length of the BE was associated significantly with progression (EAC <6 cm, 0.09%/y vs EAC ≥ 6 cm, 0.65%/y; P = 0.001). CONCLUSIONS: There is a lower incidence of dysplasia and EAC among patients with NDBE than previously reported. Because most patients are cancer free after a long-term follow-up period, surveillance intervals might be lengthened, especially for patients with shorter segments of BE.
Authors: Prateek Sharma; David A Katzka; Neil Gupta; Jaffer Ajani; Navtej Buttar; Amitabh Chak; Douglas Corley; Hashem El-Serag; Gary W Falk; Rebecca Fitzgerald; John Goldblum; Frank Gress; David H Ilson; John M Inadomi; Ernest J Kuipers; John P Lynch; Frank McKeon; David Metz; Pankaj J Pasricha; Oliver Pech; Richard Peek; Jeffrey H Peters; Alessandro Repici; Stefan Seewald; Nicholas J Shaheen; Rhonda F Souza; Stuart J Spechler; Prashanth Vennalaganti; Kenneth Wang Journal: Gastroenterology Date: 2015-08-19 Impact factor: 22.682
Authors: Milli Gupta; Prasad G Iyer; Lori Lutzke; Emmanuel C Gorospe; Julian A Abrams; Gary W Falk; Gregory G Ginsberg; Anil K Rustgi; Charles J Lightdale; Timothy C Wang; David I Fudman; John M Poneros; Kenneth K Wang Journal: Gastroenterology Date: 2013-03-15 Impact factor: 22.682
Authors: Rebecca J Critchley-Thorne; Lucas C Duits; Jeffrey W Prichard; Jon M Davison; Blair A Jobe; Bruce B Campbell; Yi Zhang; Kathleen A Repa; Lia M Reese; Jinhong Li; David L Diehl; Nirag C Jhala; Gregory Ginsberg; Maureen DeMarshall; Tyler Foxwell; Ali H Zaidi; D Lansing Taylor; Anil K Rustgi; Jacques J G H M Bergman; Gary W Falk Journal: Cancer Epidemiol Biomarkers Prev Date: 2016-05-13 Impact factor: 4.254
Authors: Milli Gupta; Timothy J Beebe; Kelly T Dunagan; Cathy D Schleck; Alan R Zinsmeister; Nicholas J Talley; G Richard Locke; Prasad G Iyer Journal: Dig Dis Sci Date: 2014-03-21 Impact factor: 3.199