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Review
. 2015 Feb;29(1):125-38.
doi: 10.1016/j.bpg.2015.01.001. Epub 2015 Jan 20.

Barrett's oesophagus: frequency and prediction of dysplasia and cancer

Gary W Falk  1
Affiliations
Review

Barrett's oesophagus: frequency and prediction of dysplasia and cancer

Gary W Falk. Best Pract Res Clin Gastroenterol. 2015 Feb.

Abstract

The incidence of oesophageal adenocarcinoma is continuing to increase at an alarming rate in the Western world today. Barrett's oesophagus is a clearly recognized risk factor for the development of oesophageal adenocarcinoma, but the overwhelming majority of patients with Barrett's oesophagus will never develop oesophageal cancer. A number of endoscopic, histologic and epidemiologic risk factors identify Barrett's oesophagus patients at increased risk for progression to high-grade dysplasia and oesophageal adenocarcinoma. Endoscopic factors include segment length, mucosal abnormalities as seemingly trivial as oesophagitis and the 12 to 6 o'clock hemisphere of the oesophagus. Both intestinal metaplasia and low grade dysplasia, the latter only if confirmed by a pathologist with expertise in Barrett's oesophagus pathologic interpretation are the histologic risk factors for progression. Epidemiologic risk factors include ageing, male gender, obesity, and smoking. Factors that may protect against the development of adenocarcinoma include a diet rich in fruits and vegetables, and the use of proton pump inhibitors, aspirin/NSAIDs and statins.

Keywords: Barrett's oesophagus; Cancer risk factors; Dysplasia; Oesophageal adenocarcinoma.

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Conflict of interest statement

Conflict of Interest Statement

I have no conflicts to declare

References

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Publication types

Supplementary concepts