PMID- 26772891
OWN - NLM
STAT- MEDLINE
DCOM- 20170809
LR  - 20181113
IS  - 1097-6779 (Electronic)
IS  - 0016-5107 (Print)
IS  - 0016-5107 (Linking)
VI  - 84
IP  - 1
DP  - 2016 Jul
TI  - Rates and predictors of progression to esophageal carcinoma in a large 
      population-based Barrett's esophagus cohort.
PG  - 40-46.e7
LID - S0016-5107(16)00005-5 [pii]
LID - 10.1016/j.gie.2015.12.036 [doi]
AB  - BACKGROUND AND AIMS: Rates of progression to esophageal adenocarcinoma in 
      subjects with Barrett's esophagus (BE) are lower than previously estimated. 
      Identification of predictors of progression will enable risk stratification of BE 
      subjects, potentially making current surveillance programs more efficient. We 
      aimed to assess the potential of demographic and lifestyle factors, obesity, and 
      medications in predicting progression in BE. METHODS: BE subjects were identified 
      from the General Practice Research Database using validated diagnostic codes. BE 
      subjects developing esophageal cancer (EC) 12 months after their index BE 
      diagnosis were defined as progressors. Time-to-event analysis was used to assess 
      the overall risk of progression to EC. Cox proportional hazards models and 
      time-varying marginal structural models were used to assess predictors of 
      progression. RESULTS: Included in the analysis were 9660 BE patients. The mean 
      age (SD) of the study subjects was 63 (13.5) years; 62.6% were men. One hundred 
      three subjects (1.1%) progressed to EC. The mean (SD) follow-up since initial 
      diagnosis was 4.8 (3.3) years. The incidence of EC was 2.23 per 1000 person-years 
      of follow-up. Increasing age, male gender, and being overweight (body mass index, 
      25-29.9) were found to be independent predictors of progression. When 
      time-varying models were used, proton pump inhibitor (PPI) and statin use were 
      protective against progression. CONCLUSIONS: In this large population-based 
      cohort of patients with BE, increasing age, male gender, and being overweight 
      predicted progression to EC, whereas PPI and statin use were protective against 
      EC development. These factors may aid in developing a risk score to predict the 
      risk of progression and chemopreventive strategies in patients with BE.
CI  - Copyright (c) 2016 American Society for Gastrointestinal Endoscopy. Published by 
      Elsevier Inc. All rights reserved.
FAU - Krishnamoorthi, Rajesh
AU  - Krishnamoorthi R
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, 
      USA.
FAU - Borah, Bijan
AU  - Borah B
AD  - Division of Health Care Policy and Research, Mayo Clinic, Rochester, Minnesota, 
      USA.
FAU - Heien, Herbert
AU  - Heien H
AD  - Division of Health Care Policy and Research, Mayo Clinic, Rochester, Minnesota, 
      USA.
FAU - Das, Ananya
AU  - Das A
AD  - Arizona Center for Digestive Health, Gilbert, Arizona, USA.
FAU - Chak, Amitabh
AU  - Chak A
AD  - Division of Gastroenterology & Hepatology, Case Western Reserve University, 
      Cleveland, Ohio, USA.
FAU - Iyer, Prasad G
AU  - Iyer PG
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, 
      USA.
LA  - eng
GR  - U54 CA163060/CA/NCI NIH HHS/United States
PT  - Journal Article
DEP - 20160107
PL  - United States
TA  - Gastrointest Endosc
JT  - Gastrointestinal endoscopy
JID - 0010505
RN  - 0 (Anti-Inflammatory Agents, Non-Steroidal)
RN  - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Proton Pump Inhibitors)
RN  - 9100L32L2N (Metformin)
RN  - Adenocarcinoma Of Esophagus
SB  - IM
CIN - Gastrointest Endosc. 2017 Feb;85(2):462-463. PMID: 28089039
MH  - Adenocarcinoma/*epidemiology
MH  - Age Factors
MH  - Aged
MH  - Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
MH  - Barrett Esophagus/*epidemiology
MH  - Body Mass Index
MH  - Databases, Factual
MH  - Diabetes Mellitus, Type 2/drug therapy/epidemiology
MH  - Disease Progression
MH  - Esophageal Neoplasms/*epidemiology
MH  - Female
MH  - Humans
MH  - Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use
MH  - Hypoglycemic Agents/therapeutic use
MH  - Incidence
MH  - Male
MH  - Metformin/therapeutic use
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Obesity/epidemiology
MH  - Overweight/*epidemiology
MH  - Proportional Hazards Models
MH  - Protective Factors
MH  - Proton Pump Inhibitors/therapeutic use
MH  - Risk Factors
MH  - Sex Factors
MH  - Time Factors
MH  - United Kingdom/epidemiology
PMC - PMC4912845
MID - NIHMS750067
EDAT- 2016/01/17 06:00
MHDA- 2017/08/10 06:00
PMCR- 2017/07/01
CRDT- 2016/01/17 06:00
PHST- 2015/08/30 00:00 [received]
PHST- 2015/12/30 00:00 [accepted]
PHST- 2016/01/17 06:00 [entrez]
PHST- 2016/01/17 06:00 [pubmed]
PHST- 2017/08/10 06:00 [medline]
PHST- 2017/07/01 00:00 [pmc-release]
AID - S0016-5107(16)00005-5 [pii]
AID - 10.1016/j.gie.2015.12.036 [doi]
PST - ppublish
SO  - Gastrointest Endosc. 2016 Jul;84(1):40-46.e7. doi: 10.1016/j.gie.2015.12.036. 
      Epub 2016 Jan 7.