Introduction Barrett’s oesophagus (BO) is a recognised risk factor for the development of Oesophageal Adenocarcinoma (OAC); a meta-analysis had estimated the annual incidence of OAC as 0.33% in non-dysplastic BO1. Scotland has one of the highest incidences of OAC in the western world. However, there is limited data on the risk of OAC in patients with BO within Scotland. The aim of this study was to estimate the risk of development of OAC in patients with non-dysplastic BO.
Method Retrospective analysis of data from our local Health Board which covers a population of over 476 000 in North-East Scotland. Patients with an endoscopic diagnosis of BO between January 2007 and December 2015 were identified from the endoscopy reporting software (Unisoft). The pathology records of these patients were reviewed, and the completeness of case ascertainment was checked by cross-referencing with the pathology database of BO diagnoses. Patients with a new endoscopic and histological diagnosis of BO (glandular mucosa with intestinal metaplasia) were included. Patients with dysplasia or OAC at initial endoscopy or within 1 year of BO diagnosis were excluded, as were patients with <1 year follow-up. Demographic data were obtained from the hospital electronic patient record. Patients were followed up until a diagnosis of OAC, high-grade dysplasia (HGD) or death.
Results Over the 9 year study period, 1545 patients were identified with an endoscopic diagnosis of BO. Of these, 658 (69% male; mean age 64 years, 52% smoking history) patients had a new histologically confirmed diagnosis of non-dysplastic BO. The entire cohort was followed-up for a median of 4 (interquartile range 2–6) years, representing 2775 person-years. OAC was diagnosed in 13 cases, with 1 additional case of HGD. Incidence rates per 100 person-years were 0.47 (95% CI: 0.21–0.72) for OAC and 0.51 (95% CI: 0.24–0.77) for OAC/HGD.
Conclusion The annual incidence of OAC in patients with non-dysplastic BO is 0.47% in NE Scotland.
. Desai TK, et al. The incidence of oesophageal adenocarcinoma in non-dysplastic Barrett’s oesophagus: a meta-analysis. Gut2012;61:970e976
Disclosure of Interest None Declared
- Barretts Oesophagus
- oesophageal cancer