Epidemiologic Risk Factors in a Comparison of a Barrett Esophagus Registry (BarrettNET) and a Case–Control Population in Germany

Abstract

Endoscopic screening for Barrett's esophagus as the major precursor lesion for esophageal adenocarcinoma is mostly offered to patients with symptoms of gastroesophageal reflux disease (GERD). However, other epidemiologic risk factors might affect the development of Barrett's esophagus and esophageal adenocarcinoma. Therefore, efforts to improve the efficiency of screening to find the Barrett's esophagus population "at risk" compared with the normal population are needed. In a cross-sectional analysis, we compared 587 patients with Barrett's esophagus from the multicenter German BarrettNET registry to 1976 healthy subjects from the population-based German KORA cohort, with and without GERD symptoms. Data on demographic and lifestyle factors, including age, gender, smoking, alcohol consumption, body mass index, physical activity, and symptoms were collected in a standardized epidemiologic survey. Increased age, male gender, smoking, heavy alcohol consumption, low physical activity, low health status, and GERD symptoms were significantly associated with Barrett's esophagus. Surprisingly, among patients stratified for GERD symptoms, these associations did not change. Demographic, lifestyle, and clinical factors as well as GERD symptoms were associated with Barrett's esophagus development in Germany, suggesting that a combination of risk factors could be useful in developing individualized screening efforts for patients with Barrett's esophagus and GERD in Germany.

Global prevalence of Barrett’s oesophagus and oesophageal cancer in individuals with gastro-oesophageal reflux: a systematic review and meta-analysis

“…However, only a fraction of patients with BO develop oesophageal adenocarcinoma, which raises important economic and clinical questions about whom to screen. [10] Numerous studies have been conducted in order to assess the correlation between symptoms of gastro-oesophageal reflux, or GORD, and the presence of BO, in an attempt to inform decisions regarding how to optimise endoscopic follow-up of their patients, in order to provide early diagnosis, detect any other complications, and reduce the associated management costs. Systematic analysis of studies that report these types of data is important, in order to provide physicians with more precise estimates of the prevalence of BO in patients with symptoms of gastro-oesophageal reflux, or GORD, in order to inform clinical practice, as well as to identify areas where further research is needed.…”

Integrated PPI- and WGCNA-Retrieval of Hub Gene Signatures Shared Between Barrett's Esophagus and Esophageal Adenocarcinoma

“…In addition, genomic analysis by restriction fragment length polymorphism indicated that the highest frequencies of Y-chromosomal haplogroups are associated with BE and EAC in White males ( Westra et al., 2020 ). Recent case–control studies demonstrate that gastroesophageal reflux disease in male patients is highly associated with the development of BE in Germany ( Schmidt et al., 2020 ). These reports supported the present results, indicating that predicted dark gray modules with the highest association with gender must have a clinically significant module.…”

Differences in Gut Virome Related to Barrett Esophagus and Esophageal Adenocarcinoma

“…In an animal experiment simulating BA reflux, overexpression of the inflammatory cells, IL-6 and TNF- α, was found [ 62 ]. This indicated that gut bacterial alterations could indirectly induce the esophageal mucosal inflammation and carcinogenesis [ 62 , 63 , 64 ]. Despite a wealth of data on the role of gut bacteria in GI tract disease, we have only recently recognized the association of gut viruses with some GI tract diseases, including CRC in which the diversity of the gut viruses is significantly increased in stool samples from CRC patients, suggesting a disease-specific signature that can be used to differentiate CRC samples from controls [ 37 ].…”