Determining Risk of Barrett’s Esophagus and Esophageal Adenocarcinoma Based on Epidemiologic Factors and Genetic Variants

Dong, Jingjing; Buas, Matthew F.; Gharahkhani, Puya; Kendall, Bradley J.; Onstad, Lynn; Zhao, Shanshan; Anderson, Lesley A.; Wu, Anna H.; Ye, Weimin; Bird, Nigel C.; Bernstein, Leslie; Chow, Wong‐Ho; Gammon, Marilie D.; Liu, Geoffrey; Caldas, Carlos; Pharoah, Paul D.P.; Risch, Harvey A.; Iyer, Prasad G.; Reid, Brian J.; Hardie, Laura J.; Lagergren, Jesper; Shaheen, Nicholas J.; Corley, Douglas A.; Fitzgerald, Rebecca C.; Whiteman, David C.; Vaughan, Thomas L.; Thrift, Aaron P.

doi:10.1053/j.gastro.2017.12.003

Cited by 68 publications

(70 citation statements)

References 40 publications

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“…These tools may require the addition of noninvasive genetic or blood biomarkers to demographic and historical variables to improve the areas under the receiver operating characteristic curves and overall performance. 117 Before we embrace the new generation of less-invasive and potentially less-expensive screening techniques and replace our current approach of using standard endoscopy for screening, these new techniques need to demonstrate high diagnostic performance characteristics, easy implementation at a primary care level, high uptake in the at-risk population, and low cost. 118 Future studies also need to focus on improved risk stratification of BE patients undergoing surveillance with the intent of performing EET for high-risk populations and extending or discontinuing surveillance in low-risk groups.…”

Section: Future Directionsmentioning

confidence: 99%

ASGE guideline on screening and surveillance of Barrett’s esophagus

Qumseya¹,

Sultan

Bain

et al. 2019

Gastrointestinal Endoscopy

299

204

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Section: Future Directionsmentioning

confidence: 99%

ASGE guideline on screening and surveillance of Barrett’s esophagus

Qumseya¹,

Sultan

Bain

et al. 2019

Gastrointestinal Endoscopy

299

204

View full text Add to dashboard Cite

“…Prior studies have identified male gender, increasing age, obesity, and, most importantly, chronic gastroesophageal reflux disease (GERD) as the risk factors associated with the development of Barrett's esophagus (BE). 1 Chronic exposure of the distal esophageal mucosal lining to acid reflux induces metaplastic change, which then predisposes the individual to the development of esophageal adenocarcinoma. BE is a mostly asymptomatic condition, and given its potential for malignant transformation, it is usually diagnosed by screening populations at high risk.…”

Section: Introductionmentioning

confidence: 99%

Independent association of obstructive sleep apnea with Barrett's esophagus

Hadi

Khan

Naqvi

et al. 2019

J of Gastro and Hepatol

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Background and Aim Current guidelines suggest screening at‐risk groups of patients for Barrett's esophagus (BE), a precursor to esophageal cancer. Although BE and obstructive sleep apnea (OSA) have common risk factors, including elevated body mass index and gastroesophageal reflux disease (GERD), the relationship between these two conditions has not been well established. Methods Retrospectively, all patients who had undergone a polysomnography and esophagogastroduodenoscopy at West Virginia University Hospital from 2013 to 2018 were identified and divided into groups on the basis of the presence or absence of OSA. Clinical course and procedure reports were reviewed to identify relevant variables. Results One thousand ninety‐one patients met inclusion criteria; 60.9% were female, and mean age of participants was 53.5 years. Univariate analysis revealed that male gender, age, diagnosis of OSA, severity of OSA, and a clinical diagnosis of GERD were associated with BE (P values < 0.05). Multiple logistic regression incorporating age, sex, clinical diagnosis of GERD, smoking history, body mass index, Helicobacter pylori status, and presence of hiatal hernia was utilized. Patients with OSA had an increased risk of BE than had those without OSA (P < 0.001, odds ratio 3.26 [1.72–6.85]). The risk increased with increasing severity of OSA, categorized in apnea–hypopnea index increments of 10. Conclusion Obstructive sleep apnea is associated with BE, a relationship that is independent of other known risk factors. Additionally, this risk increases with increasing severity of OSA. Future efforts should determine if patients with severe OSA need to be screened for BE due to its potential for causing esophageal cancer.

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“…Risk models incorporating both genetic and nongenetic factors have previously been developed for predicting risks of various cancers. However, recent studies from our working group and others have found that adding inherited genetic information to a risk model using only clinical and lifestyle factors did not improve discriminatory ability for predicting oesophageal cancer development in the general population . Future research should assess whether or not genetic factors or somatic mutations may improve discrimination in the setting of neoplastic progression in Barrett's oesophagus patients.…”

Section: Discussionmentioning

confidence: 88%

“…Multiple risk models have been derived (and some externally validated) for predicting Barrett's oesophagus and oesophageal adenocarcinoma . However, few models exist in the setting of risk prediction among patients with Barrett's oesophagus.…”

Section: Discussionmentioning

confidence: 99%

External validation of a model to determine risk of progression of Barrett’s oesophagus to neoplasia

Kunzmann

Thrift

Johnston

et al. 2019

Aliment Pharmacol Ther

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Summary Background A risk prediction model containing sex, smoking history, Barrett's oesophagus length and presence of low‐grade dysplasia was found to identify individuals at a higher risk of progression to oesophageal adenocarcinoma or high‐grade dysplasia. Aim To externally validate the model predicting risk of progression from Barrett's oesophagus to neoplasia and assess the predictive utility of additional factors. Methods We conducted a retrospective cohort study among individuals from the population‐based Northern Ireland Barrett's register with a histologically confirmed diagnosis of Barrett's oesophagus (with intestinal metaplasia) between 1993 and 2005. The association between a points based model and risk of progression to high‐grade dysplasia or oesophageal adenocarcinoma until 2010 was assessed using Cox Proportional Hazards model. Model performance was assessed using area under the receiver operating characteristics curves (AUROC), sensitivity and specificity. Results We identified 1198 individuals with Barrett's oesophagus of whom 54 progressed. The model discriminated reasonably well between progressors and nonprogressors, with an AUROC of 0.70 (95% CI 0.63‐0.78). When categorised into low, intermediate and high risk groups, the AUROC was 0.68 (95% CI 0.61‐0.74). Compared to using data on dysplasia and segment length for risk stratification, the model resulted in a net reclassification improvement of 20.9%. Conclusions This external validation provides further evidence that a model based on sex, smoking, Barrett's segment length and baseline low‐grade dysplasia may help to risk stratify patients after an initial diagnosis of Barrett's oesophagus. The model also performed better than the use of low‐grade dysplasia status alone for risk‐stratification.

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Determining Risk of Barrett’s Esophagus and Esophageal Adenocarcinoma Based on Epidemiologic Factors and Genetic Variants

Cited by 68 publications

References 40 publications

ASGE guideline on screening and surveillance of Barrett’s esophagus

ASGE guideline on screening and surveillance of Barrett’s esophagus

Independent association of obstructive sleep apnea with Barrett's esophagus

External validation of a model to determine risk of progression of Barrett’s oesophagus to neoplasia

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