Barrett’s Metaplasia and Colonic Neoplasms: A Significant Association in a 203,534-Patient Study
- 194 Downloads
Background and Aim
The presence of an association between Barrett’s metaplasia and colonic neoplasia has remained controversial. The aim of the study was to test the presence of this association, using a large national database.
From a computerized database of surgical pathology reports, we selected 203,000 subjects who underwent colonoscopy and esophago-gastro-duodenoscopy with biopsy results available from both procedures. In a case–control study we compared the occurrence of Barrett’s metaplasia in patients with and without various types of colonic neoplasms.
Barrett’s metaplasia occurred more frequently among patients with hyperplastic polyps (OR = 2.14, 95 % CI 2.02–2.27), adenomatous polyps (2.52, 2.41–2.64), advanced adenomas (2.10, 1.90–2.32), villous adenomas or adenomas with high-grade (HG) dysplasia (2.45, 2.28–2.64), and colonic adenocarcinomas (1.75, 1.39–2.22). The association between Barrett’s metaplasia and colonic neoplasm applied similarly to polyps of different size, number and location within the large bowel. These types of association could also be confirmed when analyzed separately for Barrett’s metaplasia characterized by low-grade or HG dysplasia, as well as esophageal adenocarcinoma.
The data support the existence of a true association between Barrett’s metaplasia and various types of colonic neoplasm. The association may be more interesting for its potential insights into the pathogenesis of the two disorders than its actual clinical implications.
KeywordsBarrett’s esophagus Colon polyps Gastroesophageal reflux disease Epidemiology of gastrointestinal disease Helicobacter pylori
Conflict of interest
Robert M. Genta is employed by Miraca Life Sciences, Irving, TX, USA. Amnon Sonnenberg is supported by a grant from Takeda Pharmaceuticals. No funding was obtained for this study.
- 9.Murphy SJ, Anderson LA, Mainie I, et al. Incidence of colorectal cancer in a population-based cohort of patients with Barrett’s oesophagus. Scand J Gastroenterol. 2005;40:1449–1453 (erratum in: Scand J Gastroenterol. 2006;41:247).Google Scholar
- 28.Levin B, Lieberman DA, McFarland B, et al. Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. Gastroenterology. 2008;134:1570–1595.PubMedCrossRefGoogle Scholar