Colorectal neoplasia in veterans is associated with Barrett's esophagus but not with proton-pump inhibitor or aspirin/NSAID use

Siersema, Peter D.; Yu, Stanley; Sahbaie, Peyman; Steyerberg, Ewout W.; Simpson, Peter; Kuipers, Ernst J.; Triadafilopoulos, George

doi:10.1016/j.gie.2005.08.043

Cited by 41 publications

(38 citation statements)

References 37 publications

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“…The main reasons for exclusion of studies during the final review were as follows (n = 10): data on mortality only (n = 1),17) data on colorectal polyp only (n = 3),18-20) or review article (n = 6) 7,21-25). The remaining 5 case-control studies were included in the final analysis 10-13,26)…”

Section: Resultsmentioning

confidence: 99%

Use of Proton Pump Inhibitor and Risk of Colorectal Cancer: A Meta-analysis of Observational Studies

et al. 2012

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BackgroundPrevious case-control studies have reported inconsistent findings regarding the association between proton pump inhibitor (PPI) use and colorectal cancer (CRC) risk. We investigated these associations using meta-analysis.MethodsWe searched MEDLINE (PubMed), EMBASE, and the Cochrane Library in April 2011. Two evaluators independently reviewed and selected articles, based on pre-determined selection criteria.ResultsOut of 737 articles meeting our initial criteria, 5 case-control studies, which involved 120,091 participants (9,514 cases and 110,577 controls), were included in the final analyses. The overall use of PPI (used vs. never or rarely used) was not significantly associated with the risk of CRC in a fixed-effects model meta-analysis of all 5 case-control studies (odds ratio [OR], 1.08; 95% confidence interval [CI], 0.96 to 1.20; I2 = 3.5%). Also, in sensitivity meta-analysis by cumulative duration of PPI use, there was no association between PPI use of 1 year or longer and the risk of colorectal cancer in a fixed-effects meta-analysis (OR, 1.09; 95% CI, 0.98 to 1.22; I2 = 0%).ConclusionAlthough hypergastrinemia could be an important factor in the pathogenesis of some colorectal cancers, our study suggests that this does not lead to significant clinical risk for most PPI users. Further prospective studies or randomized controlled trials related to PPI use and colorectal cancer risk are needed to investigate this association.

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Section: Resultsmentioning

confidence: 99%

Use of Proton Pump Inhibitor and Risk of Colorectal Cancer: A Meta-analysis of Observational Studies

et al. 2012

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“…Some of the studies reported that EAC carried a higher risk of colonic neoplasia than esophageal squamous cancer [4, 6]. Even large, population-based studies have shown conflicting findings, with some indicating increased risk of colonic neoplasia [3, 6–8], while others did not [14, 15]. The difficulty in interpreting those studies is due to the small number of patients in some studies [1, 2, 9–13] and lack of true control groups in others [1, 12, 13].…”

Section: Introductionmentioning

confidence: 99%

Higher prevalence of colon polyps in patients with Barrett's esophagus: a case-control study

Kumaravel

Thota

Lee

et al. 2014

Gastroenterology Report

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Background and aims: Barrett’s esophagus (BE) and colorectal neoplasms share similar risk factors. Previous studies have shown variable prevalence of colon polyps in patients with BE. Our aims were to determine the prevalence and incidence of colon polyps in patients with BE, compared to those without BE.Methods: In this case-control study, the study group included patients, aged 50–75 years, with biopsy-proven BE, who underwent colonoscopy at Cleveland Clinic from January 2002 to December 2011. The control group consisted of age- and sex-matched patients who underwent colonoscopy and also an endoscopy with no evidence of BE during the same time period. Exclusion criteria for both groups were family- or personal previous history of colon cancer or polyps, prior colonic resection, inflammatory bowel disease and familial polyposis syndromes. Patient demographics, comorbidities, medication use and endoscopic and colonoscopic details were collected, including biopsy results.Results: A total of 519 patients were included in the study; 173 patients with BE in the study group and 346 without BE in the control group. Mean age at index colonoscopy was 61 ± 8 years and 75% of patients were male. On index colonoscopy, patients with BE were more likely to have polyps than controls (45% vs 32%, respectively; P = 0.003). Patients underwent between one and five colonoscopies during the follow-up. On multivariate analysis—after adjusting for age, gender and diabetes—patients with BE were 80% more likely to have any type of polyp, and 50% more likely to have adenomas found during colonoscopy.Conclusions: Patients with BE had higher prevalence and incidence of colon polyps. This has important clinical implications for screening and surveillance in BE patients.

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“…1). 11,12,28,31,32 Using the method of meta-analysis to combine these data, the results showed a significant correlation between the presence of Barrett's esophagus and that of colonic polyps, with an odds-ratio of 1.8 (95 percent CI, 1.4Y2.3).…”

Section: Discussionmentioning

confidence: 99%

“…However, other researchers have not identified these associations. 10,11 Because some of these studies were markedly flawed in design, Siersema et al 12 established a well-designed, case-control study that compared patients with Barrett's esophagus with healthy control subjects. The results of this study confirmed the relationship between colonic polyps and Barrett's esophagus.…”

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confidence: 99%

High Prevalence of Colonic Polyps in White Males with Esophageal Adenocarcinoma

Bollschweiler

Schloesser

Leers

et al. 2009

Diseases of the Colon &Amp; Rectum

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Colorectal neoplasia in veterans is associated with Barrett's esophagus but not with proton-pump inhibitor or aspirin/NSAID use

Cited by 41 publications

References 37 publications

Use of Proton Pump Inhibitor and Risk of Colorectal Cancer: A Meta-analysis of Observational Studies

Use of Proton Pump Inhibitor and Risk of Colorectal Cancer: A Meta-analysis of Observational Studies

Higher prevalence of colon polyps in patients with Barrett's esophagus: a case-control study

High Prevalence of Colonic Polyps in White Males with Esophageal Adenocarcinoma

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