Alcohol and the Risk of Barrett's Esophagus: A Pooled Analysis from the International BEACON Consortium

Abstract

Background Results from studies examining the association between alcohol consumption and the risk of Barrett’s esophagus have been inconsistent. We assessed the risk of Barrett’s esophagus associated with total and beverage-specific alcohol consumption by pooling individual participant data from five case-control studies participating in the international Barrett’s and Esophageal Adenocarcinoma Consortium (BEACON). Methods For analysis there were 1282 population-based controls, 1418 controls with gastroesophageal reflux disease (GERD) and 1169 patients with Barrett’s esophagus (cases). We estimated study-specific odds ratios (OR) and 95% confidence intervals (95% CI) using multivariable logistic regression models adjusted for age, sex, body mass index (BMI), education, smoking status, and GERD symptoms. Summary risk estimates were obtained by random effects models. We also examined potential effect modification by sex, BMI, GERD symptoms and cigarette smoking. Results For comparisons with population-based controls, while there was a borderline statistically significant inverse association between any alcohol consumption and the risk of Barrett’s esophagus (any vs. none, summary OR=0.77, 95% CI 0.60–1.00), risk did not decrease in a dose-response manner (ptrend=0.72). Among alcohol types, wine was associated with a moderately reduced risk of Barrett’s esophagus (any vs. none, OR=0.71, 95% CI 0.52–0.98); however, there was no consistent dose-response relationship (ptrend=0.21). We found no association with alcohol consumption when cases were compared with GERD controls. Similar associations were observed across all strata of BMI, GERD symptoms and cigarette smoking. Conclusions Consistent with findings for esophageal adenocarcinoma, we found no evidence that alcohol consumption increases the risk of Barrett’s esophagus.

Asia-Pacific consensus on the management of gastro-oesophageal reflux disease: an update focusing on refractory reflux disease and Barrett's oesophagus

“…This association was also observed by Tseng et al in a Taiwanese study 145. Alcohol is not regarded as a risk factor 154 . H. pylori has been shown to be a negative risk factor in both Asia and the Western world 155 156.…”

Risk Profiles for Barrett’s Esophagus Differ between New and Prevalent, and Long- and Short-Segment Cases

“…While our results may not be generalizable to women and non-veterans, because BE disproportionately affects men and whites, the veteran population is adequate to study risk factors for BE. Furthermore, our previously published results from this VA-based study have been generally consistent with results from BE studies conducted in the U.S., Ireland and Australia [5,17,18,25]. …”

“…Emerging risk factors include lower gluteofemoral obesity [13] and shorter height [14]. However, studies of BE have reported conflicting results for associations with various other risk factors, including tobacco smoking [15,16], alcohol consumption [15,17], use of nonsteroidal anti-inflammatory drugs (NSAIDs) [18], bisphosphonates [19], as well as contrasting magnitudes of association with “known” risk factors [20]. …”

A case of simultaneous esophageal squamous cell carcinoma and Barrett’s adenocarcinoma

“…Similar mechanisms might also be operating for Barrett's adenocarcinoma and require further study. In contrast, recent analyses have suggested that drinking is not involved in Barrett's carcinogenesis, while others state that appropriate quantities of alcohol can decrease susceptibility to Barrett's adenocarcinoma [20]. Several other conflicting risk factors exist between the conditions.…”