Studies reporting association with Barrett's oesophagus length and sex with cancer progression
| Study | Year | No of patients/studies | Study design | Length of Barrett's oesophagus | Gender (male (M) vs female (F)) |
|---|---|---|---|---|---|
| Desai et al91 | 2011 | 967 patients with SSBO (16 studies) vs a pool of 11 434 with NDBO (57 studies) | Meta-analysis | The annual incidence of OAC was 0.19% (95% CI 0.08 to 0.34) in SSBO as opposed to 0.33% (95% CI 0.28 to 0.38) overall | Not reported |
| Yousef et al102 | 2008 | 6 studies with information on SSBO vs 26 studies with information on LSBO | Meta-analysis | The annual incidence of OAC was 0.61% (95% CI 3.1 to 12.2) in SSBO as opposed to 0.67% in LSBO (95% CI 5.2 to 8.6) | OAC incidence: 1.02% per year (95% CI 0.63% to 1.64%) in M and 0.45% (95% CI 0.22% to 0.92%) in F |
| Thomas et al101 | 2007 | 258 patients with SSBO vs 960 with LSBO (6 studies) | Meta-analysis | Non-significant trend towards reduction in risk of developing cancer in SSBO (RR 0.55, 95% CI 0.19 to 1.5). Patients who developed cancer had significantly longer Barrett's segments (p<0.002) | Not reported |
| Hvid-Jensen et al90 | 2011 | 11 028 patients with Barrett's | Cohort study | Not available | OAC incidence: 0.15% per year (95% CI 0.11% to 0.19%) in M and 0.05% (95% CI 0.03% to 0.1%) in F |
| Bhat et al37 | 2011 | 681 patients with SSBO vs 947 with LSBO | Cohort study (8522 patients with Barrett's) | Data on Barrett's length only available for <20% of patients. Incidence of OAC was 0.07% (95% CI 0.02% to 0.20%) in SSBO and 0.22% (95% CI 0.13% to 0.37%) in LSBO. Significant in the univariate analysis | OAC incidence: 0.17% per year (95% CI 0.13% to 0.22%) in M and 0.08% (95% CI 0.05% to 0.12%) in F |
| Wani et al105 | 2011 | 1000 patients with Barrett's <6 cm vs 362 with Barrett's >6 cm | Cohort study (1204 patients with Barrett's oesophagus) | The length of the Barrett's oesophagus was associated significantly with progression. Barrett's oesophagus <6 cm, 0.09% (95% CI 0.03% to 0.24%) vs Barrett's oesophagus ≥6 cm, 0.65% (95% CI 0.33% to 1.25%); p=0.001) | HGD/OAC incidence: 0.66% per year (95% CI 0.48% to 0.91%) in M and 0.44% (95% CI 0.14% to 1.36%) in F |
| Sikkema et al104 | 2011 | 713 patients with Barrett's oesophagus >2 cm | Prospective cohort study | A longer length of Barrett's was independent predictor of progression to HGD or OAC (RR 1.11 per cm increase; 95% CI 1.01 to 1.2) | M had a RR of 1.7 (95% CI 0.6 to 4.5) compared with F |
| Wani et al103 | 2011 | 210 patients with Barrett's and LGD | Multicentre cohort study | No significant difference (p=0 .39) in the incidence of cancer in patients with SSBO (0.29% (95% CI 0.07% to 1.16%)) compared with LSBO (0.6% (95% CI 0.22% to 1.62%)) | Not reported |
| Wong et al106 | 2010 | 155 patients with SSBO and 93 with LSBO | Retrospective cohort study | Length >3 cm was found to be associated with dysplasia (OR 1.2; 95% CI 1.07 to 1.34; p=0.004) | Not reported (predominantly M population) |
| Weston et al107 | 2004 | 550 patient with Barrett's (309 with SSBO and 241 with LSBO) | Prospective cohort study | Length was associated with progression to HGD/OAC (HR 1.15, 95% CI 1.03 to 1.29). Log-rank tests showed significant differences only between group <3 cm vs group 6 cm (p<0.001) | Not reported (predominantly M population) |
| Hage et al84 | 2004 | 104 patients with LSBO | Retrospective cohort study | A longer length of Barrett's was associated with an increased risk of progression to HGD or cancer (p<0.02) | Not reported |
| Gopal et al108 | 2003 | 309 patients | Retrospective cohort study | Greater prevalence of dysplasia in LSBO vs SSBO (23% vs 9%, p=0.0001). Length independently associated with dysplasia in multivariate analysis | Gender not associated with dysplasia (predominantly M population) |
| Avidan et al113 | 2002 | 131 cases of Barrett's with HGD/OAC and 1189 controls with benign Barrett's oesophagus | Retrospective case–controlstudy | OR for cancer 1.17 (95% CI 1.07 to 1.27) for any increase in the Barrett's length by 1 cm | M gender had a 1.2 OR for HGD/OAC (95% CI 0.12 to 12.16) |
| Rudolph et al109 | 2000 | 309 patients followed-up prospectively (83 with SSBO and 226 with LSBO) | Prospective cohort study | A 5 cm difference in segment length was associated with a 1.7-fold (95% CI 0.8 to 3.8) increase in cancer risk | Not reported |
| Hirota et al110 | 1999 | 13 patients with LSBO and 50 with SSBO | Retrospective cohort study (833 patients referred for OGD) | Higher prevalence of OAC in LSBO compared with SSBO (p=0.043) | Not reported |
| O'Connor et al111 | 1999 | 136 patients with Barrett's (30 with SSBO and 106 with LSBO) | Prospective cohort study | The relative risk of LGD, HGD or cancer increased by 1.42 (95% CI 1.07 to 1.89) for each 3 cm increase in length of Barrett's epithelium (p=0.02) | Not reported |
| Menke-Pluymers et al112 | 1993 | 96 patients with benign Barrett's and 62 with cancer in Barrett's oesophagus | Retrospective case–control | Greater length associated with increased risk of cancer: a doubling of any given length involved a 1.7 increase in risk (p<0.05). | M gender had a borderline association with OAC (p=0.06) |
HGD, high-grade dysplasia; LGD, low-grade dysplasia; LSBO, long segment of Barrett's; NDBO, non-dysplastic Barrett's; OAC, oesophageal adenocarcinoma; OGD, oesophagogastroduodenoscopy; SSBO, short segment of Barrett's.