Risk Factors for the Development of Barrett's Esophagus and Esophageal Adenocarcinoma: A Systematic Review and Meta‐Analysis

ABSTRACT Background Barrett's esophagus (BE) is the most widely established precursor to esophageal adenocarcinoma (EAC). Despite current screening guidelines, more than 90% of EAC patients lack a previous diagnosis of BE. We performed a systematic review and meta‐analysis to identify the most...

Full description

Saved in:
Bibliographic Details
Main Authors: Kais Antonios, Daniel Aintabi, Patricia McNally, Elliot Berinstein, Priyata Dutta, Nicholas Sampson, Sichao Wang, Claudia Villarreal Carrillo, Brahm Singh, Marjan Haider, Richard A. Shellenberger
Format: Article
Language:English
Published: Wiley 2025-03-01
Series:Cancer Reports
Subjects:
Online Access:https://doi.org/10.1002/cnr2.70168
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850207577106808832
author Kais Antonios
Daniel Aintabi
Patricia McNally
Elliot Berinstein
Priyata Dutta
Nicholas Sampson
Sichao Wang
Claudia Villarreal Carrillo
Brahm Singh
Marjan Haider
Richard A. Shellenberger
author_facet Kais Antonios
Daniel Aintabi
Patricia McNally
Elliot Berinstein
Priyata Dutta
Nicholas Sampson
Sichao Wang
Claudia Villarreal Carrillo
Brahm Singh
Marjan Haider
Richard A. Shellenberger
author_sort Kais Antonios
collection DOAJ
description ABSTRACT Background Barrett's esophagus (BE) is the most widely established precursor to esophageal adenocarcinoma (EAC). Despite current screening guidelines, more than 90% of EAC patients lack a previous diagnosis of BE. We performed a systematic review and meta‐analysis to identify the most important risk factors for the development of BE or EAC. Recent Findings PubMed.gov, Ovid Medline, Embase, and Cochrane Library were searched through March 15, 2024. Studies comparing characteristics of patients with endoscopically diagnosed BE or EAC to control groups satisfied our inclusion criteria. Dual extraction provided data for random‐effects meta‐analyses. Sufficient data were extracted from 54 included studies to perform our meta‐analyses. There were five risk factors with significant associations for the development of BE: symptoms of gastroesophageal reflux at least once weekly (OR, 3.56; 95% confidence interval [CI], 2.03–6.25; p = 0.004) tobacco smoking (OR, 1.41; 95% CI, 1.30–1.51; p < 0.001); alcohol use (OR, 1.37; 95% CI, 1.10–1.71; p = 0.008); male gender (OR, 1.36; 95% CI, 1.19–1.57; p < 0.001); and obesity (BMI > 30 kg/m2) (OR, 1.23; 95% CI, 1.09–1.39; p = 0.003). Tobacco smoking was significantly associated with the diagnosis of EAC (OR, 2.15; 95% CI, 1.85–2.43; p < 0.001). Conclusion Five risk factors showed significant associations with the development of BE and one with the development of EAC, with over a three‐fold increase in BE for patients with gastroesophageal reflux more than once weekly. These data could prove useful in developing diagnostic paradigms with higher emphasis on patients experiencing more frequent acid reflux.
format Article
id doaj-art-d3b8e6f686aa4c739a830027aebcdaf9
institution OA Journals
issn 2573-8348
language English
publishDate 2025-03-01
publisher Wiley
record_format Article
series Cancer Reports
spelling doaj-art-d3b8e6f686aa4c739a830027aebcdaf92025-08-20T02:10:28ZengWileyCancer Reports2573-83482025-03-0183n/an/a10.1002/cnr2.70168Risk Factors for the Development of Barrett's Esophagus and Esophageal Adenocarcinoma: A Systematic Review and Meta‐AnalysisKais Antonios0Daniel Aintabi1Patricia McNally2Elliot Berinstein3Priyata Dutta4Nicholas Sampson5Sichao Wang6Claudia Villarreal Carrillo7Brahm Singh8Marjan Haider9Richard A. Shellenberger10Trinity Health Ann Arbor Hospital Ann Arbor Michigan USATrinity Health Ann Arbor Hospital Ann Arbor Michigan USATrinity Health Ann Arbor Hospital Ann Arbor Michigan USATrinity Health Ann Arbor Hospital Ann Arbor Michigan USATrinity Health Ann Arbor Hospital Ann Arbor Michigan USAMichigan State University East Lansing Michigan USAMichigan State University East Lansing Michigan USATrinity Health Ann Arbor Hospital Ann Arbor Michigan USATrinity Health Ann Arbor Hospital Ann Arbor Michigan USATrinity Health Ann Arbor Hospital Ann Arbor Michigan USAInternal Medicine Trinity Health Ann Arbor Hospital Ypsilanti Michigan USAABSTRACT Background Barrett's esophagus (BE) is the most widely established precursor to esophageal adenocarcinoma (EAC). Despite current screening guidelines, more than 90% of EAC patients lack a previous diagnosis of BE. We performed a systematic review and meta‐analysis to identify the most important risk factors for the development of BE or EAC. Recent Findings PubMed.gov, Ovid Medline, Embase, and Cochrane Library were searched through March 15, 2024. Studies comparing characteristics of patients with endoscopically diagnosed BE or EAC to control groups satisfied our inclusion criteria. Dual extraction provided data for random‐effects meta‐analyses. Sufficient data were extracted from 54 included studies to perform our meta‐analyses. There were five risk factors with significant associations for the development of BE: symptoms of gastroesophageal reflux at least once weekly (OR, 3.56; 95% confidence interval [CI], 2.03–6.25; p = 0.004) tobacco smoking (OR, 1.41; 95% CI, 1.30–1.51; p < 0.001); alcohol use (OR, 1.37; 95% CI, 1.10–1.71; p = 0.008); male gender (OR, 1.36; 95% CI, 1.19–1.57; p < 0.001); and obesity (BMI > 30 kg/m2) (OR, 1.23; 95% CI, 1.09–1.39; p = 0.003). Tobacco smoking was significantly associated with the diagnosis of EAC (OR, 2.15; 95% CI, 1.85–2.43; p < 0.001). Conclusion Five risk factors showed significant associations with the development of BE and one with the development of EAC, with over a three‐fold increase in BE for patients with gastroesophageal reflux more than once weekly. These data could prove useful in developing diagnostic paradigms with higher emphasis on patients experiencing more frequent acid reflux.https://doi.org/10.1002/cnr2.70168Barrett's esophaguscancer epidemiologycancer screeningearly detectionesophageal adenocarcinomagastroesophageal reflux
spellingShingle Kais Antonios
Daniel Aintabi
Patricia McNally
Elliot Berinstein
Priyata Dutta
Nicholas Sampson
Sichao Wang
Claudia Villarreal Carrillo
Brahm Singh
Marjan Haider
Richard A. Shellenberger
Risk Factors for the Development of Barrett's Esophagus and Esophageal Adenocarcinoma: A Systematic Review and Meta‐Analysis
Cancer Reports
Barrett's esophagus
cancer epidemiology
cancer screening
early detection
esophageal adenocarcinoma
gastroesophageal reflux
title Risk Factors for the Development of Barrett's Esophagus and Esophageal Adenocarcinoma: A Systematic Review and Meta‐Analysis
title_full Risk Factors for the Development of Barrett's Esophagus and Esophageal Adenocarcinoma: A Systematic Review and Meta‐Analysis
title_fullStr Risk Factors for the Development of Barrett's Esophagus and Esophageal Adenocarcinoma: A Systematic Review and Meta‐Analysis
title_full_unstemmed Risk Factors for the Development of Barrett's Esophagus and Esophageal Adenocarcinoma: A Systematic Review and Meta‐Analysis
title_short Risk Factors for the Development of Barrett's Esophagus and Esophageal Adenocarcinoma: A Systematic Review and Meta‐Analysis
title_sort risk factors for the development of barrett s esophagus and esophageal adenocarcinoma a systematic review and meta analysis
topic Barrett's esophagus
cancer epidemiology
cancer screening
early detection
esophageal adenocarcinoma
gastroesophageal reflux
url https://doi.org/10.1002/cnr2.70168
work_keys_str_mv AT kaisantonios riskfactorsforthedevelopmentofbarrettsesophagusandesophagealadenocarcinomaasystematicreviewandmetaanalysis
AT danielaintabi riskfactorsforthedevelopmentofbarrettsesophagusandesophagealadenocarcinomaasystematicreviewandmetaanalysis
AT patriciamcnally riskfactorsforthedevelopmentofbarrettsesophagusandesophagealadenocarcinomaasystematicreviewandmetaanalysis
AT elliotberinstein riskfactorsforthedevelopmentofbarrettsesophagusandesophagealadenocarcinomaasystematicreviewandmetaanalysis
AT priyatadutta riskfactorsforthedevelopmentofbarrettsesophagusandesophagealadenocarcinomaasystematicreviewandmetaanalysis
AT nicholassampson riskfactorsforthedevelopmentofbarrettsesophagusandesophagealadenocarcinomaasystematicreviewandmetaanalysis
AT sichaowang riskfactorsforthedevelopmentofbarrettsesophagusandesophagealadenocarcinomaasystematicreviewandmetaanalysis
AT claudiavillarrealcarrillo riskfactorsforthedevelopmentofbarrettsesophagusandesophagealadenocarcinomaasystematicreviewandmetaanalysis
AT brahmsingh riskfactorsforthedevelopmentofbarrettsesophagusandesophagealadenocarcinomaasystematicreviewandmetaanalysis
AT marjanhaider riskfactorsforthedevelopmentofbarrettsesophagusandesophagealadenocarcinomaasystematicreviewandmetaanalysis
AT richardashellenberger riskfactorsforthedevelopmentofbarrettsesophagusandesophagealadenocarcinomaasystematicreviewandmetaanalysis