Epidemiology of Barrett’s oesophagus and oesophageal adenocarcinoma

Abstract

Barrett's oesophagus is a condition characterised by metaplastic changes in the oesophagus and is a precursor to oesophageal adenocarcinoma. Oesophageal adenocarcinoma is recognised as being responsible for an increasing number of cancerrelated deaths, especially in the western world. A deluge of risk factors have been described in the literature. Some of the important ones include gastroesophageal reflux disease, Helicobacter pylori infection, lifestyle factors like alcohol consumption, smoking, and dietary factors, and metabolic diseases like obesity. It also poses challenges in diagnosis and treatment despite recent advances in diagnostics, surgery, and other therapies. This is a narrative review of the findings of multiple studies that were retrieved from electronic databases like PubMed, Google Scholar, Scopus, Medline, Embase, and Cochrane. We summarise the current knowledge regarding the epidemiology and various risk factors for the development of Barrett's oesophagus and oesophageal adenocarcinoma. Streszczenie Przełyk Barretta charakteryzuje się występowaniem zmian metaplastycznych w przełyku i jest stanem przedrakowym przełyku. Gruczolakorak przełyku odpowiada za coraz większą liczbę zgonów z powodu raka, zwłaszcza na Zachodzie. W piśmiennictwie wskazano wiele czynników ryzyka. Do najważniejszych z nich należą: choroba refluksowa przełyku, zakażenie Helicobacter pylori, czynniki związane ze stylem życia, takie jak spożywanie alkoholu, palenie tytoniu i czynniki żywieniowe, oraz choroby metaboliczne, takie jak otyłość. Schorzenie to stwarza problemy w zakresie diagnostyki i leczenia pomimo dokonanych ostatnio postępów w dziedzinie diagnostyki, leczenia operacyjnego i innych terapii. W artykule przedstawiono przegląd wyników wielu badań, które pobrano z elektronicznych baz danych, takich jak PubMed, Google Scholar, Scopus, Medline, Embase i Cochrane. Podsumowano także aktualną wiedzę na temat epidemiologii i czynników ryzyka rozwoju przełyku Barretta i gruczolakoraka przełyku.

Helicobacter pylori infection is associated with reduced risk of Barrett’s esophagus: a meta-analysis and systematic review

“…Current epidemiological studies present a consistent, rapidly increasing incidence of EAC in the United States and most other western countries, especially among males, with an observed or estimated start between 1960 and 1990, while the incidence of esophageal squamous cell carcinoma is stable or declining in all racial groups [ 3 , 4 ]. The etiology of EAC is multifactorial, and Barrett’s esophagus (BE) is a premalignant lesion that is observed in the majority of patients with EAC, and carries a risk of eventual development of EAC that is up to 30- to 125-fold higher than that in patients without this condition [ 5 , 6 ]. Previous studies have identified several risk factors for the development of BE, including male sex, older age, smoking, white race, obesity, hiatal hernia, and gastroesophageal reflux disease (GERD) [ 7 , 8 ].…”

Clinical importance of serum CEA and CA-19-9 levels in oesophagogastric junction adenocarcinomas

“…Moreover, in a recent review, oesophagogastric junction cancers were reported to have a mortality rate of 85%, so screening is vital for precaution of oesophagogastric junction tumours. Also, the 5-year overall survival rate in oesophagogastric junction (OGJ) tumours ranges from 23 to 38% [ 2 , 3 ].…”