Risk Factors for Barrett's Oesophagus in Individuals With Gastro-Oesophageal Reflux Symptoms: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Leonardo Henry Eusebi ◽  
Andrea Telese ◽  
Giovanna Grazia Cirota ◽  
Rehan Haidry ◽  
Rocco Maurizio Zagari ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Meta Analysis ◽  
Barrett’S Oesophagus ◽  
Oesophageal Reflux ◽  
Barrett's Oesophagus ◽  
Reflux Symptoms

scholarly journals Global prevalence of Barrett’s oesophagus and oesophageal cancer in individuals with gastro-oesophageal reflux: a systematic review and meta-analysis

Gut ◽  
2020 ◽  
pp. gutjnl-2020-321365 ◽  
Author(s):  
Leonardo Henry Eusebi ◽  
Giovanna Grazia Cirota ◽  
Rocco Maurizio Zagari ◽  
Alexander Charles Ford
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Barrett’S Oesophagus ◽  
Oesophageal Reflux ◽  
Oesophageal Adenocarcinoma ◽  
Low Grade ◽  
Barrett's Oesophagus ◽  
Global Prevalence ◽  
Pooled Prevalence ◽  
Geographical Regions

ObjectivesChronic gastro-oesophageal reflux might lead to the development of Barrett’s oesophagus (BO) or even oesophageal adenocarcinoma. There has been no definitive systematic review and meta-analysis of data to estimate global prevalence of BO or oesophageal adenocarcinoma in individuals with gastro-oesophageal reflux.DesignWe searched MEDLINE, Embase and Embase Classic to identify cross-sectional surveys that reported prevalence of BO or oesophageal adenocarcinoma in adults with gastro-oesophageal reflux. We extracted prevalence for all studies, both for endoscopically suspected and histologically confirmed cases. We calculated pooled prevalence according to study location, symptom frequency and sex, as well as ORs with 95% CIs.ResultsOf the 4963 citations evaluated, 44 reported prevalence of endoscopically suspected and/or histologically confirmed BO. Prevalence of BO among individuals with gastro-oesophageal reflux varied according to different geographical regions ranging from 3% to 14% for histologically confirmed BO with a pooled prevalence of 7.2% (95% CI 5.4% to 9.3%), whereas pooled prevalence for endoscopically suspected BO was 12.0% (95% CI 5.5% to 20.3%). There was heterogeneity in many of our analyses. Prevalence of BO was significantly higher in men, both for endoscopically suspected (OR=2.1; 95% CI 1.6 to 2.8) and histologically confirmed BO (OR=2.3; 95% CI 1.7 to 3.2). Dysplasia was present in 13.9% (95% CI 8.9% to 19.8%) of cases of histologically confirmed BO, 80.7% of which was low-grade.ConclusionThe prevalence of Barrett’s oesophagus among individuals with gastro-oesophageal reflux varied strikingly among countries, broadly resembling the geographical distribution of gastro-oesophageal reflux itself. Prevalence of BO was significantly higher in men.

scholarly journals Multitrait genetic association analysis identifies 50 new risk loci for gastro-oesophageal reflux, seven new loci for Barrett’s oesophagus and provides insights into clinical heterogeneity in reflux diagnosis

Gut ◽  
2021 ◽  
pp. gutjnl-2020-323906
Author(s):  
Jue-Sheng Ong ◽  
Jiyuan An ◽  
Xikun Han ◽  
Matthew H Law ◽  
Priyanka Nandakumar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multiple Testing ◽  
Association Studies ◽  
Barrett’S Oesophagus ◽  
Oesophageal Reflux ◽  
Oesophageal Adenocarcinoma ◽  
Specific Gene ◽  
Genome Wide Association Studies ◽  
Disease Heterogeneity ◽  
Barrett's Oesophagus

ObjectiveGastro-oesophageal reflux disease (GERD) has heterogeneous aetiology primarily attributable to its symptom-based definitions. GERD genome-wide association studies (GWASs) have shown strong genetic overlaps with established risk factors such as obesity and depression. We hypothesised that the shared genetic architecture between GERD and these risk factors can be leveraged to (1) identify new GERD and Barrett’s oesophagus (BE) risk loci and (2) explore potentially heterogeneous pathways leading to GERD and oesophageal complications.DesignWe applied multitrait GWAS models combining GERD (78 707 cases; 288 734 controls) and genetically correlated traits including education attainment, depression and body mass index. We also used multitrait analysis to identify BE risk loci. Top hits were replicated in 23andMe (462 753 GERD cases, 24 099 BE cases, 1 484 025 controls). We additionally dissected the GERD loci into obesity-driven and depression-driven subgroups. These subgroups were investigated to determine how they relate to tissue-specific gene expression and to risk of serious oesophageal disease (BE and/or oesophageal adenocarcinoma, EA).ResultsWe identified 88 loci associated with GERD, with 59 replicating in 23andMe after multiple testing corrections. Our BE analysis identified seven novel loci. Additionally we showed that only the obesity-driven GERD loci (but not the depression-driven loci) were associated with genes enriched in oesophageal tissues and successfully predicted BE/EA.ConclusionOur multitrait model identified many novel risk loci for GERD and BE. We present strong evidence for a genetic underpinning of disease heterogeneity in GERD and show that GERD loci associated with depressive symptoms are not strong predictors of BE/EA relative to obesity-driven GERD loci.

Systematic review with meta‐analysis: neoplasia detection rate and post‐endoscopy Barrett's neoplasia in Barrett's oesophagus

2021 ◽  
Author(s):  
Nour Hamade ◽  
Amrit K. Kamboj ◽  
Rajesh Krishnamoorthi ◽  
Siddharth Singh ◽  
Leslie C. Hassett ◽  
...  
Keyword(s):  
Systematic Review ◽  
Detection Rate ◽  
Meta Analysis ◽  
Barrett’S Oesophagus ◽  
Barrett's Oesophagus

scholarly journals PTH-043 The accuracy of ultrathin endoscopy in the diagnosis of barrett’s oesophagus: systematic review and meta-analysis

2019 ◽  
Author(s):  
John McGoran ◽  
Jacobo Ortiz Fernández-Sordo ◽  
John SDe Caestecker ◽  
Rehan Haidry ◽  
Laurence B Lovat ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Barrett’S Oesophagus ◽  
Barrett's Oesophagus

Gastro-oesophageal reflux symptoms, oesophagitis and Barrett's oesophagus in the general population: the Loiano-Monghidoro study

Gut ◽  
2008 ◽  
Vol 57 (10) ◽  
pp. 1354-1359 ◽  
Author(s):  
R M Zagari ◽  
L Fuccio ◽  
M-A Wallander ◽  
S Johansson ◽  
R Fiocca ◽  
...  
Keyword(s):  
General Population ◽  
Barrett’S Oesophagus ◽  
Oesophageal Reflux ◽  
Barrett's Oesophagus ◽  
Reflux Symptoms

Estimating neoplasia detection rate (NDR) in patients with Barrett’s oesophagus based on index endoscopy: a systematic review and meta-analysis

Gut ◽  
2019 ◽  
Vol 68 (12) ◽  
pp. 2122-2128 ◽  
Author(s):  
Sravanthi Parasa ◽  
Madhav Desai ◽  
Anusha Vittal ◽  
Viveksandeep T Chandrasekar ◽  
Asad Pervez ◽  
...  
Keyword(s):  
Systematic Review ◽  
Detection Rate ◽  
Data Extraction ◽  
Meta Analysis ◽  
Quality Measure ◽  
Barrett’S Oesophagus ◽  
Oesophageal Adenocarcinoma ◽  
Cochrane Library ◽  
Barrett's Oesophagus ◽  
Pooled Prevalence

BackgroundBiopsies are obtained to confirm intestinal metaplasia and rule out prevalent dysplasia and cancer when Barrett’s oesophagus (BE) is detected at index upper endoscopy (oesophagogastroduodenoscopy [EGD]).AimThe purpose of this systematic review was to obtain summary estimates of the prevalence of high-grade dysplasia (HGD) and oesophageal adenocarcinoma (EAC) associated with BE during index EGD for chronic GERD symptoms, defined as neoplasia detection rate (NDR) which could be used as a quality measure.MethodsAn extensive search was performed within PUBMED, EMBASE and the Cochrane Library databases to identify studies in which patients underwent index endoscopy for the evaluation of the presence of BE. Two reviewers independently evaluated both the study eligibility and methodological quality and data extraction. A random-effects model (REM) based on the binomial distribution was used to calculate the pooled effects of the prevalence of BE-associated dysplasia and EAC.ResultsFor the calculation of dysplasia and EAC prevalence rates, a total of 11 studies with 10 632 patients met the inclusion criteria including 80.4% men with a mean age of 58.7 years and average BE length of 3.5 cm. The pooled prevalence of EAC, HGD and LGD was 3%(95% CI 2 to 5, 9 studies: 396/10 539 patients), 3%(95% CI 2 to 5 [REM], 9 studies: 388/10 539 patients) and 10%(95% CI 7 to 15 [REM], 10 studies: 907/8945 patients), respectively. For NDR, that is, the pooled prevalence of HGD/EAC was 7%(95% CI 4 to 10 [REM], 10 studies: 795/10 632 patients).ConclusionNDR is approximately 4% and could be used as a quality measure.

scholarly journals Acid-suppressive medications and risk of oesophageal adenocarcinoma in patients with Barrett's oesophagus: a systematic review and meta-analysis

Gut ◽  
2013 ◽  
Vol 63 (8) ◽  
pp. 1229-1237 ◽  
Author(s):  
Siddharth Singh ◽  
Sushil Kumar Garg ◽  
Preet Paul Singh ◽  
Prasad G Iyer ◽  
Hashem B El-Serag
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Barrett’S Oesophagus ◽  
Oesophageal Adenocarcinoma ◽  
Barrett's Oesophagus
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