Barrett’s esophagus—a condition characterized by abnormal cells in the lower part of the esophagus—may carry a lower risk of esophageal cancer than previously reported. These results were published in the Journal of the National Cancer Institute.
The esophagus is the tube that carries food and liquids from the mouth to the stomach. Barrett’s esophagus affects an estimated 1% of U.S. adults, and is characterized by the development of abnormal cells in the lining of the lower part of the esophagus. The condition does not produce symptoms. Regular exposure to stomach acid is thought to be an important contributing factor, and Barrett’s esophagus is commonly found in people with gastroesophageal reflux disease (GERD).
Barrett’s esophagus is known to be linked with an increased risk of esophageal cancer, but estimates regarding the frequency of cancer in people with Barrett’s esophagus have varied widely.
To get a better estimate of the risk of esophageal cancer, researchers in Northern Ireland evaluated information from one of the largest registries of Barrett’s esophagus in the world. The registry included more than 8,500 patients.
- During roughly seven years of follow-up, 79 people were diagnosed with esophageal cancer, 16 people were diagnosed with cancer of the gastric cardia (the upper part of the stomach), and 36 people were diagnosed with precancerous changes known as high-grade dysplasia.
- The rate of these three conditions combined was 0.22% per year. Previous estimates have generally ranged from 0.58% per year to 3% per year.
- The risk of cancer or high-grade dysplasia was higher among men, among people between the ages of 60-69, and among those who had low-grade dysplasia or specialized intestinal metaplasia at the time of their initial biopsy.
These results suggest that esophageal cancer may be less common among people with Barrett’s esophagus than has been previously reported. Cancer risk varies by several factors, however, including gender, age, and biopsy findings. Accurate estimates of risk are an important part of developing effective strategies for managing Barrett’s esophagus.
 National Digestive Diseases Information Clearinghouse (NDDIC). Barrett’s esophagus. Accessed July 5, 2011.
 Bhat S, Coleman HG, Yousef F et al. Risk of malignant progression in Barrett’s esophagus patients: results from a large population-based study. Journal of the National Cancer Institute. Early online publication June 16, 2011.