Characteristics and Neoplastic Progression in Barrett’s Esophagus: A Large Population-Based Study from Iceland

<b>Background:</b> Barrett’s esophagus (BE) is a known precursor to esophageal adenocarcinoma (EAC). However, reports on incidence and progression-to-neoplasm rates have been very variable and conflicting. The aims of the study were to evaluate the characteristics of BE and its progressi...

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Main Authors: Ken Namikawa, Melkorka Sverrisdottir, Hilmar Freyr Fridgeirsson, Hjalti Dagur Hjaltason, Helgi Kristinn Sigmundsson, Jon Gunnlaugur Jonasson, Einar Stefan Bjornsson, Magnus Konradsson
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Language:English
Published: MDPI AG 2025-03-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/6/684
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author Ken Namikawa
Melkorka Sverrisdottir
Hilmar Freyr Fridgeirsson
Hjalti Dagur Hjaltason
Helgi Kristinn Sigmundsson
Jon Gunnlaugur Jonasson
Einar Stefan Bjornsson
Magnus Konradsson
author_facet Ken Namikawa
Melkorka Sverrisdottir
Hilmar Freyr Fridgeirsson
Hjalti Dagur Hjaltason
Helgi Kristinn Sigmundsson
Jon Gunnlaugur Jonasson
Einar Stefan Bjornsson
Magnus Konradsson
author_sort Ken Namikawa
collection DOAJ
description <b>Background:</b> Barrett’s esophagus (BE) is a known precursor to esophageal adenocarcinoma (EAC). However, reports on incidence and progression-to-neoplasm rates have been very variable and conflicting. The aims of the study were to evaluate the characteristics of BE and its progression to neoplasm in a large homogeneous population. <b>Methods:</b> This was a retrospective population-based study with patients identified from 11 institutions through the databases in two centralized pathology laboratories. Demographics and relevant clinicopathological features were obtained from medical records among patients with a pathologically confirmed BE by the presence of intestinal metaplasia between 2003 and 2022. <b>Results:</b> A total of 1388 patients were identified with BE: 948 were men (69%); the median age at diagnosis was 62 years (IQR, 53–72). The ratio of long-segment BE to short-segment BE was significantly higher in patients ≥ 60 years (1.15, 284/248) than those ≤ 60 years (0.77, 205/265) (<i>p</i> = 0.0025). At BE diagnosis, 9.4% had neoplasms: LGD (<i>n</i> = 65), HGD (<i>n</i> = 16), and EAC (<i>n</i> = 49). Among 1258 non-dysplastic BE (NDBE) patients, 4.6% developed a neoplasm—LGD (<i>n</i> = 35), HGD (<i>n</i> = 8), and EAC (<i>n</i> = 15)—with a median observation-period of 5 years (IQR, 3–7). Overall, 160 cases with neoplasms were diagnosed in this BE cohort; 130 (74%) were present at initial BE diagnosis, and 58 (26%) progressed to neoplasms from NDBE. <b>Conclusions:</b> The ratio of long-segment BE was found to be significantly higher in patients ≥ 60 years. Around 9% of the patients were diagnosed as harboring a neoplasm concomitantly with BE, accounting for approximately 74% of all neoplasms. After a median follow-up of 5 years, about 5% of BE showed dysplastic or malignant progression.
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spelling doaj-art-7ec83aad914f41198aeb52805f8dd4eb2025-08-20T03:43:26ZengMDPI AGDiagnostics2075-44182025-03-0115668410.3390/diagnostics15060684Characteristics and Neoplastic Progression in Barrett’s Esophagus: A Large Population-Based Study from IcelandKen Namikawa0Melkorka Sverrisdottir1Hilmar Freyr Fridgeirsson2Hjalti Dagur Hjaltason3Helgi Kristinn Sigmundsson4Jon Gunnlaugur Jonasson5Einar Stefan Bjornsson6Magnus Konradsson7Department of Gastroenterology, Landspitali—The National University Hospital of Iceland, 101 Reykjavik, IcelandFaculty of Medicine, University of Iceland, 101 Reykjavik, IcelandFaculty of Medicine, University of Iceland, 101 Reykjavik, IcelandFaculty of Medicine, University of Iceland, 101 Reykjavik, IcelandFaculty of Medicine, University of Iceland, 101 Reykjavik, IcelandFaculty of Medicine, University of Iceland, 101 Reykjavik, IcelandDepartment of Gastroenterology, Landspitali—The National University Hospital of Iceland, 101 Reykjavik, IcelandDepartment of Gastroenterology, Landspitali—The National University Hospital of Iceland, 101 Reykjavik, Iceland<b>Background:</b> Barrett’s esophagus (BE) is a known precursor to esophageal adenocarcinoma (EAC). However, reports on incidence and progression-to-neoplasm rates have been very variable and conflicting. The aims of the study were to evaluate the characteristics of BE and its progression to neoplasm in a large homogeneous population. <b>Methods:</b> This was a retrospective population-based study with patients identified from 11 institutions through the databases in two centralized pathology laboratories. Demographics and relevant clinicopathological features were obtained from medical records among patients with a pathologically confirmed BE by the presence of intestinal metaplasia between 2003 and 2022. <b>Results:</b> A total of 1388 patients were identified with BE: 948 were men (69%); the median age at diagnosis was 62 years (IQR, 53–72). The ratio of long-segment BE to short-segment BE was significantly higher in patients ≥ 60 years (1.15, 284/248) than those ≤ 60 years (0.77, 205/265) (<i>p</i> = 0.0025). At BE diagnosis, 9.4% had neoplasms: LGD (<i>n</i> = 65), HGD (<i>n</i> = 16), and EAC (<i>n</i> = 49). Among 1258 non-dysplastic BE (NDBE) patients, 4.6% developed a neoplasm—LGD (<i>n</i> = 35), HGD (<i>n</i> = 8), and EAC (<i>n</i> = 15)—with a median observation-period of 5 years (IQR, 3–7). Overall, 160 cases with neoplasms were diagnosed in this BE cohort; 130 (74%) were present at initial BE diagnosis, and 58 (26%) progressed to neoplasms from NDBE. <b>Conclusions:</b> The ratio of long-segment BE was found to be significantly higher in patients ≥ 60 years. Around 9% of the patients were diagnosed as harboring a neoplasm concomitantly with BE, accounting for approximately 74% of all neoplasms. After a median follow-up of 5 years, about 5% of BE showed dysplastic or malignant progression.https://www.mdpi.com/2075-4418/15/6/684Barrett’s esophagusprogressiondysplasiaesophageal adenocarcinomaepidemiologyIceland
spellingShingle Ken Namikawa
Melkorka Sverrisdottir
Hilmar Freyr Fridgeirsson
Hjalti Dagur Hjaltason
Helgi Kristinn Sigmundsson
Jon Gunnlaugur Jonasson
Einar Stefan Bjornsson
Magnus Konradsson
Characteristics and Neoplastic Progression in Barrett’s Esophagus: A Large Population-Based Study from Iceland
Diagnostics
Barrett’s esophagus
progression
dysplasia
esophageal adenocarcinoma
epidemiology
Iceland
title Characteristics and Neoplastic Progression in Barrett’s Esophagus: A Large Population-Based Study from Iceland
title_full Characteristics and Neoplastic Progression in Barrett’s Esophagus: A Large Population-Based Study from Iceland
title_fullStr Characteristics and Neoplastic Progression in Barrett’s Esophagus: A Large Population-Based Study from Iceland
title_full_unstemmed Characteristics and Neoplastic Progression in Barrett’s Esophagus: A Large Population-Based Study from Iceland
title_short Characteristics and Neoplastic Progression in Barrett’s Esophagus: A Large Population-Based Study from Iceland
title_sort characteristics and neoplastic progression in barrett s esophagus a large population based study from iceland
topic Barrett’s esophagus
progression
dysplasia
esophageal adenocarcinoma
epidemiology
Iceland
url https://www.mdpi.com/2075-4418/15/6/684
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