Barrett esophagus frequency and predictors of dysplasia or cancer in Barrett esophagus

Abstract

OBJECTIVE: Identificating factors associated with an increased risk for dysplasia and cancer development among patients with Barrett esophagus would aid better patient care and improve risk stratification approaches. This study aimed at examining the frequency of Barrett esophagus and factors predicting the presence of dysplasia and cancer among patients with Barrett esophagus. PATIENTS AND METHODS: Adult patients that underwent upper gastrointestinal endoscopic ex-amination for gastroesophageal complaints were screened in this retrospective, cross-sectional study; and patients diagnosed with Barrett esophagus were included in the analysis. Frequency of dysplasia/cancer and its predictors were examined. RESULTS: Among 10,404 endoscopic examinations performed during the study period, 143 patients (1.4%) were diagnosed with Barrett esophagus. Among patients with Barrett esophagus, the frequency for high-grade dysplasia, low grade dysplasia, and adenocarcinoma was 2.8%, 2.1%, and 1.4%, respectively. On multivariate analysis, age >= 55 years (OR, 11.1 [95%CI: 2.0-61.4], p=0.006) and long segment Barrett esophagus (OR, 5.7 [95%CI: 1.2-27.8], p=0.031) emerged as significant independent predictors for dysplasia/cancer. CONCLUSIONS: Frequency of Barrett esophagus in our population seems to be different than figures reported from different geographical regions. Advanced age and long Barrett segment on endoscopic examination are associated with the presence of concomitant dysplasia/cancer on pathological examination. Larger studies with prospective methodology are warranted.