Alcohol Types and Sociodemographic Characteristics as Risk Factors for Barrett's Esophagus

Kubo, Ai; Levin, Theodore R.; Block, Gladys; Rumore, Gregory J.; Quesenberry, Charles P.; Buffler, Patricia A.; Corley, Douglas A.

doi:10.1053/j.gastro.2008.11.042

Cited by 88 publications

(77 citation statements)

References 37 publications

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“…Any smoking during a patient's lifetime was associated with a greater risk for BE compared with non-GERD controls (OR 1.4, 95% CI 1.2-1.7), but not when compared with patients with chronic GERD (OR 1.2, 95% CI 0.8-1.9), suggesting that the increased risk of BE associated with tobacco usage may be mediated via increasing GERD ( 35 ). In contrast to tobacco usage, alcohol consumption has not been demonstrated to be signifi cantly associated with the risk for development of BE ( 36,37 ). In fact, there are data suggesting a possible protective eff ect of wine consumption, with ORs ranging from 0.44 (95% CI 0.2-0.99) to 0.71 (95% CI 0.52-0.98) ( 37,38 ).…”

Section: Summary Of Evidencementioning

confidence: 94%

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ACG Clinical Guideline: Diagnosis and Management of Barrett’s Esophagus

Shaheen

Falk

Iyer

et al. 2016

American Journal of Gastroenterology

1,355

1,412

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Recent population studies suggest that gastroesophageal refl ux disease (GERD) is increasing in prevalence, both in the United States and worldwide ( 1,2 ). Th e diagnosis of GERD is associated with a 10-15% risk of Barrett's esophagus (BE), a change of the normal squamous epithelium of the distal esophagus to a columnar-lined intestinal metaplasia (IM). Risk factors associated with the development of BE include long-standing GERD, male gender, central obesity ( 3 ), and age over 50 years ( 4,5 ). Th e goal of a screening and surveillance program for BE is to identify individuals at risk for progression to esophageal adenocarcinoma (EAC), a malignancy that has been increasing in incidence since the 1970s ( 6,7 ).Th e purpose of this guideline is to review the defi nition and epidemiology of BE, available screening modalities for BE detection, rationale and methods for surveillance, and available treatment modalities including medical, endoscopic, and surgical techniques. In order to evaluate the level of evidence and strength of recommendations, we used the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system ( 8 ). Th e level of evidence ranged from "high" (implying that further research was unlikely to change the authors' confi dence in the estimate of the eff ect) to "moderate" (further research would be likely to have an impact on the confi dence in the estimate of eff ect) to "low" (further research would be expected to have an important impact on the confi dence in the estimate of the eff ect and would be likely to change the estimate) or "very low" (any estimate of eff ect is very uncertain). Th e strength of a recommendation was graded as "strong" when the desirable eff ects of an intervention clearly outweighed the undesirable eff ects and as "conditional" when there was uncertainty about the tradeoff s. We used meta-analyses or systematic reviews when available, followed by clinical trials and cohort and case-control studies. In order to determine the level Barrett's esophagus (BE) is among the most common conditions encountered by the gastroenterologist. In this document, the American College of Gastroenterology updates its guidance for the best practices in caring for these patients. These guidelines continue to endorse screening of high-risk patients for BE; however, routine screening is limited to men with refl ux symptoms and multiple other risk factors. Acknowledging recent data on the low risk of malignant progression in patients with nondysplastic BE, endoscopic surveillance intervals are attenuated in this population; patients with nondysplastic BE should undergo endoscopic surveillance no more frequently than every 3-5 years. Neither routine use of biomarker panels nor advanced endoscopic imaging techniques (beyond high-defi nition endoscopy) is recommended at this time. Endoscopic ablative therapy is recommended for patients with BE and high-grade dysplasia, as well as T1a esophageal adenocarcinoma. Based on recent level 1 evidence, endoscopic ablative therapy is ...

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Section: Summary Of Evidencementioning

confidence: 94%

“…In contrast to tobacco usage, alcohol consumption has not been demonstrated to be signifi cantly associated with the risk for development of BE ( 36,37 ). In fact, there are data suggesting a possible protective eff ect of wine consumption, with ORs ranging from 0.44 (95% CI 0.2-0.99) to 0.71 (95% CI 0.52-0.98) ( 37,38 ).…”

Section: Summary Of Evidencementioning

confidence: 96%

ACG Clinical Guideline: Diagnosis and Management of Barrett’s Esophagus

Shaheen

Falk

Iyer

et al. 2016

American Journal of Gastroenterology

1,355

1,412

View full text Add to dashboard Cite

show abstract

“…Alcohol consumption, and its possible relationship with BE, has been studied in a few case-control studies. Null associations with alcohol have been observed (15,17), and one study (18) found alcohol to be a risk factor. Inverse associations have been reported for wine consumption (15,17).…”

Section: Introductionmentioning

confidence: 99%

A Prospective Cohort Study on Overweight, Smoking, Alcohol Consumption, and Risk of Barrett's Esophagus

Steevens

Schouten

Driessen

et al. 2011

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: Barrett's esophagus (BE) is a precursor lesion of esophageal adenocarcinoma. Besides gastroesophageal reflux, possible risk factors for BE include overweight, cigarette smoking, and alcohol consumption. Our objective was to study these associations by using prospective data.Methods: The prospective Netherlands Cohort Study, initiated in 1986, consists of 120,852 men and women, aged 55 to 69 years at baseline. At baseline, all subjects completed a questionnaire on dietary habits and lifestyle. After 16.3 years of follow-up, 370 BE cases with specialized intestinal metaplasia and 3,866 subcohort members were available for case-cohort analysis. Cox proportional hazards models were used to calculate incidence rate ratios (RR) and 95% CIs.Results

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“…30,31 Although some previous studies have shown inverse correlation with wine use 32,33 but positive correlation with liquor use 34 and BE development, some authors have argued that alcohol itself, not the type of the different drinks, was directly related to GERD. 35 Our study found a significant relationship between BE and alcohol abuse and tobacco use, and demonstrates that BE development increases with alcohol abuse and smoking.…”

Section: Discussionmentioning

confidence: 96%

Utility of Endoscopy for Diagnosis of Barrett in a Non-Western Society: Endoscopic and Histopathologic Correlation

Ege¹,

Dinç

Yildiz

et al. 2015

International Surgery

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Barrett esophagus is metaplastic transformation of esophageal squamous epithelium to columnar cells. A total of 1370 patients who had undergone upper endoscopy because of dyspeptic complaints were enrolled in the study. Age, sex, alcohol and smoking habits, body mass index, type and duration of symptoms (heartburn, epigastric pain, nausea, vomiting), and use of proton pump inhibitors were evaluated in all patients and recorded on standardized forms. Patients were grouped as normal esophagogastric junction, long-segment Barrett esophagus, and short-segment Barrett. Biopsies were taken from at least 6 points and examined histopathologically. Of the 1370 patients involved in the study, 748 (54.6%) were female and 622 (45.4%) were male. Mean age was 47.2 6 15.30 years. Short-segment Barrett esophagus was detected in 16 patients, and long-segment Barrett was detected in 11 patients. Although Barrett esophagus was detected in 11 cases that were suspected to have Barrett during endoscopy, histopathology was negative in all cases that were not suspected to have Barrett. Barrett esophagus prevalence was significantly higher in people who used alcohol and tobacco and who had hiatal hernia. Although Barrett esophagus was detected in 40% of cases that were suspected to have Barrett during endoscopy, histopathology was negative in all cases that were not suspected to have Barrett. Barrett was detected in 40.7% of cases that were suspected to have Barrett during endoscopy; histopathology was negative in all cases that were not suspected to have Barrett. Senstivity of endoscopy is questionable in detection of short-segment Barrett.

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Alcohol Types and Sociodemographic Characteristics as Risk Factors for Barrett's Esophagus

Cited by 88 publications

References 37 publications

ACG Clinical Guideline: Diagnosis and Management of Barrett’s Esophagus

ACG Clinical Guideline: Diagnosis and Management of Barrett’s Esophagus

A Prospective Cohort Study on Overweight, Smoking, Alcohol Consumption, and Risk of Barrett's Esophagus

Utility of Endoscopy for Diagnosis of Barrett in a Non-Western Society: Endoscopic and Histopathologic Correlation

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