Table 5

Studies reporting association with Barrett's oesophagus length and sex with cancer progression

StudyYearNo of patients/studiesStudy designLength of Barrett's oesophagusGender (male (M) vs female (F))
Desai et al912011967 patients with SSBO (16 studies) vs a pool of 11 434 with NDBO (57 studies)Meta-analysisThe 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) overallNot reported
Yousef et al10220086 studies with information on SSBO vs 26 studies with information on LSBOMeta-analysisThe 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 al1012007258 patients with SSBO vs 960 with LSBO (6 studies)Meta-analysisNon-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 al90201111 028 patients with Barrett'sCohort studyNot availableOAC 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 al372011681 patients with SSBO vs 947 with LSBOCohort 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 analysisOAC 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 al10520111000 patients with Barrett's <6 cm vs 362 with Barrett's >6 cmCohort 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 al1042011713 patients with Barrett's oesophagus >2 cmProspective cohort studyA 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 al1032011210 patients with Barrett's and LGDMulticentre cohort studyNo 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 al1062010155 patients with SSBO and 93 with LSBORetrospective cohort studyLength >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 al1072004550 patient with Barrett's (309 with SSBO and 241 with LSBO)Prospective cohort studyLength 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 al842004104 patients with LSBORetrospective cohort studyA longer length of Barrett's was associated with an increased risk of progression to HGD or cancer (p<0.02)Not reported
Gopal et al1082003309 patientsRetrospective cohort studyGreater prevalence of dysplasia in LSBO vs SSBO (23% vs 9%, p=0.0001). Length independently associated with dysplasia in multivariate analysisGender not associated with dysplasia (predominantly M population)
Avidan et al1132002131 cases of Barrett's with HGD/OAC and 1189 controls with benign Barrett's oesophagusRetrospective case–controlstudyOR for cancer 1.17 (95% CI 1.07 to 1.27) for any increase in the Barrett's length by 1 cmM gender had a 1.2 OR for HGD/OAC (95% CI 0.12 to 12.16)
Rudolph et al1092000309 patients followed-up prospectively (83 with SSBO and 226 with LSBO)Prospective cohort studyA 5 cm difference in segment length was associated with a 1.7-fold (95% CI 0.8 to 3.8) increase in cancer riskNot reported
Hirota et al1101999 13 patients with LSBO and 50 with SSBORetrospective cohort study (833 patients referred for OGD)Higher prevalence of OAC in LSBO compared with SSBO (p=0.043)Not reported
O'Connor et al1111999136 patients with Barrett's (30 with SSBO and 106 with LSBO)Prospective cohort studyThe 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 al112199396 patients with benign Barrett's and 62 with cancer in Barrett's oesophagusRetrospective 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.