Risk of adenocarcinoma in Barrett's oesophagus: population based study

Abstract

hospital intubation without drugs was hopeless, 3 but we found that 8% of patients survived. The number was small, with the lower limit of the confidence interval of 0.2% just equal to the mean survival reported by the helicopter service.Anaesthesia and intubation can be complicated by head and facial injuries, cervical fractures, risk of oesophageal intubation, aspiration, circulatory deterioration, and increased intracerebral pressure. The environment out of hospital is different from in hospital and support and resources are limited. We question whether anaesthesia and intubation of trauma patients can be mastered and routine be maintained by ambulance personnel.

Risk of oesophageal cancer in Barrett's oesophagus and in gastro-oesophageal reflux

“…The only larger cohort study of oesophageal cancer in Barrett's, recently published from Northern Ireland, 33 found an incidence of oesophageal adenocarcinoma of 4/1000 person years, which is similar to our estimate of 5/1000 for all oesophageal cancers. Although we were unable to adjust for socioeconomic status, our cohorts were closely matched for age, sex, and community to minimise the effect of confounding by these and other related variables.…”

Aspirin, Nonsteroidal Anti-inflammatory Drugs, and the Risks of Cancers of the Esophagus

“…We assessed the frequency of symptoms of gastroesophageal reflux 10 years before diagnosis, defined as the presence of heartburn (''a burning pain behind the breastbone after eating'') or acid reflux (''a sour taste from acid or bile rising up into the mouth or throat''). For analysis, we used the highest reported frequency for either symptom and, consistent with previous reports, defined ''frequent symptoms'' as those occurring at least weekly during the 10 years before diagnosis (50,51).…”

Risk factors for Barrett’s oesophagus and oesophageal adenocarcinoma: Results from the FINBAR study

“…It is unknown if all oesophageal adenocarcinomas arise from Barrett' s oesophagus but there is some evidence to suggest that this is the case [7] . In surveillance programs of Barrett' s oesophagus only a minority of patients develop oesophageal adenocarcinoma [8][9][10][11][12] raising the question of what factors are implicated in the development of oesophageal adenocarcinoma from Barrett's oesophagus.…”

“…Gastro-oesophageal reflux is strongly associated with oesophageal adeno carcinoma [14][15][16][17]23,24] and is thought to be the main predisposing factor for Barrett's oesophagus [20] . A small proportion of gastro-oesophageal reflux sufferers develop Barrett's oesophagus [25][26][27][28] and approximately 0.5% of Barrett's oesophagus patients progress to oesophageal adenocarcinoma each year [8,[29][30][31] indicating that factors apart from gastro-oesophageal reflux are involved in the development of Barrett's oesophagus and in its progression to oesophageal adenocarcinoma. Several risk factors for oesophageal adenocarcinoma have been established, including a high body mass index (BMI) [15,16,24,[32][33][34] , smoking [13,15,19,34,35] and possibly a diet low in fruit and vegetables [16,24,[36][37][38] .…”