Esophageal adenocarcinoma in a first-degree relative increases risk for esophageal adenocarcinoma in patients with Barrett’s esophagus

Background The significance of a family history of esophageal adenocarcinoma in the progression to esophageal adenocarcinoma in patients with Barrett’s esophagus has not been thoroughly evaluated. The purpose of this study is to evaluate the presence of esophageal adenocarcinoma in a first-degree re...

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Bibliographic Details
Published in:United European gastroenterology journal 2019-03, Vol.7 (2), p.225-229
Main Authors: Tofani, Christina J, Gandhi, Kunjal, Spataro, Joseph, Yoo, Joseph, Murphy, Megan, Mohan, Neena, Daitch, Zachary, Shah, Apeksha, Janowski, Raymond, Huntley, Colin, Dabbish, Nooreen, Keith, Scott, Coben, Robert, Cohen, Sidney, Kastenberg, David, Infantolino, Anthony
Format: Article
Language:English
Subjects:
Adenocarcinoma - diagnosis
Adenocarcinoma - epidemiology
Adenocarcinoma - etiology
Adenocarcinoma - therapy
Adult
Barrett Esophagus - complications
Barrett Esophagus - diagnosis
Barrett Esophagus - epidemiology
Barrett Esophagus - therapy
Barrett's esophagus
Disease Susceptibility
esophageal cancer
Esophageal Neoplasms - diagnosis
Esophageal Neoplasms - epidemiology
Esophageal Neoplasms - etiology
Esophageal Neoplasms - therapy
Esophagoscopy
Esophagostomy
family history
Female
Follow-Up Studies
Genetic Predisposition to Disease
Humans
inheritance
Male
Middle Aged
Nuclear Family
Original
Radiofrequency Ablation
Retrospective Studies
Risk Assessment
Risk Factors
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Summary:Background The significance of a family history of esophageal adenocarcinoma in the progression to esophageal adenocarcinoma in patients with Barrett’s esophagus has not been thoroughly evaluated. The purpose of this study is to evaluate the presence of esophageal adenocarcinoma in a first-degree relative in patients with Barrett’s esophagus. Methods A retrospective cohort study was conducted of patients with Barrett’s esophagus at a tertiary care center undergoing radiofrequency ablation. Family history, demographics, and pathology and endoscopy reports were assessed in all patients. Findings Three hundred and one patients with Barrett’s esophagus were assessed. Nineteen patients who had a diagnosis of esophageal adenocarcinoma on index endoscopy were excluded. Nineteen (6.7%) patients had a first-degree relative with esophageal adenocarcinoma. Four (21.1%) of these patients progressed to esophageal adenocarcinoma. Of patients without first-degree relative with esophageal adenocarcinoma 22/263 (8.7%) progressed to esophageal adenocarcinoma. In a logistic regression model adjusted for sex and the number of radiofrequency ablation treatments, we found that family history of esophageal adenocarcinoma was a significant independent predictor of progression to esophageal adenocarcinoma (odds ratio = 5.55, 95% confidence interval: 1.47–20.0). Conclusion Our study indicates that Barrett’s esophagus patients with a first-degree family member with esophageal adenocarcinoma are at 5.5-fold higher risk for disease progression to esophageal adenocarcinoma. Family history of esophageal adenocarcinoma in Barrett’s esophagus patients should be considered in patient surveillance and radiofrequency ablation treatment, beyond recommended guidelines.
ISSN:2050-6406
2050-6414
DOI:10.1177/2050640618817098