The risk of esophageal adenocarcinoma associated with Barrett's esophagus and gastroesophageal reflux disease: A retrospective cohort study in U.S. veterans
Patients with Barrett's esophagus (BE) and gastroesophageal reflux disease (GERD) are at a higher risk of developing esophageal adenocarcinoma (EA). We examined this risk in two large national cohorts of patients with BE and GERD alone and provided risk ratios comparing the risk in both cohorts. This was a retrospective cohort study of US veterans with BE and GERD alone diagnosed between 2003 and 2009, identified from a total of 121 Veterans' Affairs facilities nationwide. All cases of EA were verified by detailed medical chart review. We identified 29,536 with BE and 486,676 patients with GERD who met our eligibility criteria. Most patients in both cohorts were men and white, with a mean age of 59.8 and 61.8 years, respectively. The incidence rate of EA in patients with BE was 3.215 per 1,000 person-years, and 0.206 per 1,000 person-years in patients with GERD alone. The incidence of EA in patients with BE increased with age compared to patients with GERD alone. The highest risk of EA in patients with BE when compared to GERD alone was in blacks (incidence rate ratio 52.221, 95%CI 22.412-125.696). BE diagnosis significantly increased the risk of EA when compared to patients with GERD alone. This was most apparent in both black and elderly patients.
Shakhatreh, Mohammad H, "The risk of esophageal adenocarcinoma associated with Barrett's esophagus and gastroesophageal reflux disease: A retrospective cohort study in U.S. veterans" (2014). Texas Medical Center Dissertations (via ProQuest). AAI1566366.