Esophageal cancer in first-degree relative increases Barrett’s risk
ORLANDO — Patients with Barrett’s esophagus who have a first-degree relative with esophageal adenocarcinoma are at 5.5-fold increased risk for progression to esophageal adenocarcinoma, according to a presenter here.
“Our study suggests that family history of esophageal adenocarcinoma is an independent risk factor for the development of esophageal adenocarcinoma in Barrett’s esophagus patients and should be carefully considered in patient surveillance and radiofrequency ablation treatment, beyond current recommended guidelines,” Christina J. Tofani, MD, of Thomas Jefferson University Hospital, said during her presentation.
While it is well-known that esophageal adenocarcinoma is a common complication of Barrett’s esophagus, the significance of family history of esophageal adenocarcinoma in disease progression among patients with Barrett’s esophagus is not well-known.
Therefore, Tofani and colleagues conducted a retrospective cohort study including 301 patients with Barrett’s esophagus undergoing radiofrequency ablation at a tertiary care center. The researchers pooled data from electronic medical records on patient age, sex, age at diagnosis of Barrett’s esophagus and esophageal adenocarcinoma, pathology and length of Barrett’s esophagus segment. They assessed information on family history in all patients, including those with and without esophageal adenocarcinoma.
Researchers excluded from the study 19 patients with intramucosal adenocarcinoma on index endoscopy.
Overall, 6.7% of patients with Barrett’s esophagus had a first-degree relative with a history of esophageal adenocarcinoma. Of these, 21.1% had disease that progressed to esophageal adenocarcinoma compared with 8.7% of patients without a first-degree relative with esophageal adenocarcinoma.
After adjusting for sex and the number of radiofrequency ablation treatments, the researchers found that family history of esophageal adenocarcinoma was a significant independent predictor for progression to adenocarcinoma (OR=5.55; 95% CI, 1.47-20).
“Family history of esophageal adenocarcinoma should be carefully considered in the care of patients with Barrett’s esophagus. Perhaps even beyond current Barrett’s esophagus surveillance and treatment guidelines,” Tofani said. – by Jennifer Southall
Reference: Tofani C, et al. Abstract 69. Presented at: World Congress of Gastroenterology at American College of Gastroenterology Annual Scientific Meeting; Oct. 13-18, 2017; Orlando, FL.
Disclosure: Tofani reports no relevant financial disclosures.