The Incidence of Adenocarcinoma in Columnar-Lined (Barrett's) Esophagus

• Published in: The New England journal of medicine Vol. 313; no. 14; pp. 857 - 859
• Main Authors: Cameron, Alan John, Ott, Beverly Jean, Payne, William Spencer
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 03.10.1985
• Subjects: Adenocarcinoma; Adenocarcinoma - etiology; Adenocarcinoma - mortality; Age; Barrett Esophagus - complications; Barrett Esophagus - mortality; Barrett's esophagus; Biological and medical sciences; Cancer; Cellular biology; Dysphagia; Endoscopy; Epithelium; Esophageal cancer; Esophageal Diseases - complications; Esophageal Neoplasms - etiology; Esophageal Neoplasms - mortality; Esophagus; Follow-Up Studies; Gastroenterology; Gastroenterology. Liver. Pancreas. Abdomen; Gastroesophageal reflux; Health risk assessment; Humans; Male; Medical sciences; Middle Aged; Patients; Risk; Time Factors; Tumors; Adenocarcinoma; Human; Risk factor; Digestive diseases; ENT disease; Esophagea; Tumor; Terminal esophagus; Epidemiology; Columnar epithelium; Esophagus
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJM198510033131404

We evaluated the risk of adenocarcinoma developing in Barrett's esophagus (esophagus lined with columnar epithelium). Mayo Clinic records were reviewed, and all cases that met predefined histologic criteria for the diagnosis of Barrett's esophagus in 1979 or earlier were included. In 18 of 122 such cases, adenocarcinoma of the esophagus and Barrett's esophagus were diagnosed simultaneously. The status of the remaining 104 cases was determined after a mean interval of 8.5 years. During this time, adenocarcinoma of the esophagus developed in 2 patients, and 24 died from other causes. We conclude that although the incidence of esophageal adenocarcinoma is increased in patients with symptomatic Barrett's esophagus, it does not occur in the majority of such patients. (N Engl J Med 1985; 313: 857–9.) IN 1950, Barrett 1 found that the normal squamous lining of the distal esophagus may be replaced by columnar epithelium. In this condition, known as Barrett's esophagus, severe gastroesophageal reflux 2 , 3 destroys the squamous epithelium, which is replaced by columnar mucosa. It is probably an acquired disorder. 4 , 5 Adenocarcinoma may arise in Barrett's esophagus. 6 This association has been noted frequently, 121 cases having been found in a recent review of the English literature. 7 Adenocarcinoma was found in 8.5 per cent of 140 patients with Barrett's esophagus in one series 8 and in 14 per cent of 877 patients in a collective review. 9 It has . . .