Omar Bakr1, Wei Zhao2, Douglas Corley2. 1. Department of Medicine, University of California Los Angeles, Los Angeles. 2. Kaiser Permanente Division of Research, Oakland, CA.
Abstract
GOALS: To identify risk factors associated with Barrett esophagus (BE) for potential improved surveillance and risk reduction. BACKGROUND: Gastroesophageal reflux disease (GERD) is a known risk factor for esophageal adenocarcinoma, but the ability of GERD symptom frequency and severity to predict presence of its putative precursor lesion, BE, is less well-defined in large, community-based populations. STUDY: We conducted a case-control study within the Kaiser Permanente Northern California population. Cases had new diagnoses of BE. To identify risk factors in the general population, we contrasted cases with population controls; to identify risk factors only among patients with GERD, we contrasted cases with GERD patients who lacked BE. RESULTS: We interviewed 953 patients; 320 patients with BE, 316 patients with GERD who lacked BE and 317 population controls. Compared with population controls, BE risk was highest among patients with the most frequent and severe GERD symptoms [odds ratio (OR), 27.00; 95% confidence interval (CI), 14.52-50.21], nocturnal symptoms (OR, 5.40; 95% CI, 3.81-7.72), and family history of GERD (OR, 2.55; 95% CI, 1.80-3.62) or BE (OR, 10.08; 95% CI, 2.83-35.84). Although at least weekly proton pump inhibitor (PPI) use was a risk factor for BE (OR, 9.85; 95% CI, 6.54-14.84), among PPI users in the general population, GERD symptoms were not strongly associated with the risk of BE. Compared with GERD controls, cases were more likely to have onset of GERD symptoms before 30 years of age (OR, 1.93; 95% CI, 1.15-3.22) and a family history of BE (OR, 3.64; 95% CI, 1.50-8.83). CONCLUSIONS: Severe and frequent GERD symptoms are strongly associated with increased risk of BE in the general population, especially in the absence of frequent PPI use. Among people with GERD, family history of BE and early age of symptom onset were stronger predictors of BE. These findings may improve identification of patients at highest risk for BE.
GOALS: To identify risk factors associated with Barrett esophagus (BE) for potential improved surveillance and risk reduction. BACKGROUND:Gastroesophageal reflux disease (GERD) is a known risk factor for esophageal adenocarcinoma, but the ability of GERD symptom frequency and severity to predict presence of its putative precursor lesion, BE, is less well-defined in large, community-based populations. STUDY: We conducted a case-control study within the Kaiser Permanente Northern California population. Cases had new diagnoses of BE. To identify risk factors in the general population, we contrasted cases with population controls; to identify risk factors only among patients with GERD, we contrasted cases with GERDpatients who lacked BE. RESULTS: We interviewed 953 patients; 320 patients with BE, 316 patients with GERD who lacked BE and 317 population controls. Compared with population controls, BE risk was highest among patients with the most frequent and severe GERD symptoms [odds ratio (OR), 27.00; 95% confidence interval (CI), 14.52-50.21], nocturnal symptoms (OR, 5.40; 95% CI, 3.81-7.72), and family history of GERD (OR, 2.55; 95% CI, 1.80-3.62) or BE (OR, 10.08; 95% CI, 2.83-35.84). Although at least weekly proton pump inhibitor (PPI) use was a risk factor for BE (OR, 9.85; 95% CI, 6.54-14.84), among PPI users in the general population, GERD symptoms were not strongly associated with the risk of BE. Compared with GERD controls, cases were more likely to have onset of GERD symptoms before 30 years of age (OR, 1.93; 95% CI, 1.15-3.22) and a family history of BE (OR, 3.64; 95% CI, 1.50-8.83). CONCLUSIONS: Severe and frequent GERD symptoms are strongly associated with increased risk of BE in the general population, especially in the absence of frequent PPI use. Among people with GERD, family history of BE and early age of symptom onset were stronger predictors of BE. These findings may improve identification of patients at highest risk for BE.
Authors: Michael B Cook; Nicholas J Shaheen; Lesley A Anderson; Carol Giffen; Wong-Ho Chow; Thomas L Vaughan; David C Whiteman; Douglas A Corley Journal: Gastroenterology Date: 2012-01-11 Impact factor: 22.682
Authors: Ai Kubo; T R Levin; Gladys Block; Gregory Rumore; Charles P Quesenberry; Patricia Buffler; Douglas A Corley Journal: Cancer Causes Control Date: 2008-10-14 Impact factor: 2.506
Authors: Lesley A Anderson; R G Peter Watson; Seamus J Murphy; Brian T Johnston; Harry Comber; Jim Mc Guigan; John V Reynolds; Liam J Murray Journal: World J Gastroenterol Date: 2007-03-14 Impact factor: 5.742
Authors: Aaron P Thrift; Jennifer R Kramer; Zeeshan Qureshi; Peter A Richardson; Hashem B El-Serag Journal: Am J Gastroenterol Date: 2013-04-09 Impact factor: 10.864
Authors: Douglas A Corley; Ai Kubo; Theodore R Levin; Gladys Block; Laurel Habel; Wei Zhao; Pat Leighton; Charles Quesenberry; Greg J Rumore; Patricia A Buffler Journal: Gastroenterology Date: 2007-04-25 Impact factor: 22.682
Authors: Jennifer J Misenhimer; Marc A Ward; Christine E Sanchez; Andrew Ngov; Rehma Shabbir; Gerald O Ogola; Carolina Orsi; Stephen G Leeds Journal: JSLS Date: 2021 Jan-Mar Impact factor: 2.172