Esophageal adenocarcinoma in a first-degree relative increases risk for esophageal adenocarcinoma in patients with Barrett's esophagus.
Publication/Presentation Date
3-1-2019
Abstract
BACKGROUND: The significance of a family history of esophageal adenocarcinoma in the progression to esophageal adenocarcinoma in patients with Barrett's esophagus has not been thoroughly evaluated. The purpose of this study is to evaluate the presence of esophageal adenocarcinoma in a first-degree relative in patients with Barrett's esophagus.
METHODS: A retrospective cohort study was conducted of patients with Barrett's esophagus at a tertiary care center undergoing radiofrequency ablation. Family history, demographics, and pathology and endoscopy reports were assessed in all patients.
FINDINGS: Three hundred and one patients with Barrett's esophagus were assessed. Nineteen patients who had a diagnosis of esophageal adenocarcinoma on index endoscopy were excluded. Nineteen (6.7%) patients had a first-degree relative with esophageal adenocarcinoma. Four (21.1%) of these patients progressed to esophageal adenocarcinoma. Of patients without first-degree relative with esophageal adenocarcinoma 22/263 (8.7%) progressed to esophageal adenocarcinoma. In a logistic regression model adjusted for sex and the number of radiofrequency ablation treatments, we found that family history of esophageal adenocarcinoma was a significant independent predictor of progression to esophageal adenocarcinoma (odds ratio = 5.55, 95% confidence interval: 1.47-20.0).
CONCLUSION: Our study indicates that Barrett's esophagus patients with a first-degree family member with esophageal adenocarcinoma are at 5.5-fold higher risk for disease progression to esophageal adenocarcinoma. Family history of esophageal adenocarcinoma in Barrett's esophagus patients should be considered in patient surveillance and radiofrequency ablation treatment, beyond recommended guidelines.
Volume
7
Issue
2
First Page
225
Last Page
229
ISSN
2050-6406
Published In/Presented At
Tofani, C. J., Gandhi, K., Spataro, J., Yoo, J., Murphy, M., Mohan, N., Daitch, Z., Shah, A., Janowski, R., Huntley, C., Dabbish, N., Keith, S., Coben, R., Cohen, S., Kastenberg, D., & Infantolino, A. (2019). Esophageal adenocarcinoma in a first-degree relative increases risk for esophageal adenocarcinoma in patients with Barrett's esophagus. United European gastroenterology journal, 7(2), 225–229. https://doi.org/10.1177/2050640618817098
Disciplines
Medicine and Health Sciences
PubMedID
31080607
Department(s)
Department of Medicine
Document Type
Article