Gender differences in Barrett’s esophagus and progression of disease: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Melquist Stephanie ◽  
Hamade Nour ◽  
Marques de Sá Inês ◽  
Kundumadam Shanker ◽  
Kennedy Kevin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Barrett’S Esophagus ◽  
Barrett's Esophagus ◽  
Meta Analysis ◽  
Gastroesophageal Junction ◽  
Neoplastic Disease ◽  
Neoplastic Progression ◽  
Screening And Surveillance ◽  
Progression Of Disease ◽  
Comprehensive Search

Summary It is known that Barrett’s esophagus (BE) and esophageal adenocarcinoma occur more commonly in men. What is unknown are the prevalence of BE and rates of neoplastic progression in women. Our aim was to determine the prevalence of Barrett’s and its progression to esophageal cancer in women through systematic review and meta-analysis. A comprehensive search was conducted using PubMed, Scopus, and Google Scholar. Studies were included that reported prevalence rates of BE or progression rates to neoplastic disease stratified by gender. Barrett’s was defined by updated criteria as salmon-colored mucosa ≥1 cm proximal to the gastroesophageal junction. Pooled rates and odds ratios (ORs) at 95% confidence interval (CI) of the prevalence of BE and its progression to neoplastic disease were calculated. Ten studies with 19,337 patients (50.6% women) reported on prevalence and six studies with 5137 patients (24.3% women) reported on neoplastic progression of disease between genders. The rate of BE in women was 1.29% ([95% CI: 0.76–2.19], I2 = 91%) compared to men at 4.66% ([95% CI: 3.31–6.53], I2 = 89%); OR: 0.33 ([95% CI: 0.27–0.42], I2 = 0%). The rate of annual progression of Barrett’s to high-grade dysplasia or adenocarcinoma was 0.62% ([95% CI: 0.22–1.75]) in women compared to 1.54% ([95% CI: 0.83–2.81], I2 = 96%) in men; OR: 0.44 ([95% CI: 0.30–0.65], I2 = 22%). This study demonstrates a 70% lower rate of prevalence and a 60% lower rate of neoplastic progression of Barrett’s in women. Future BE guidelines should tailor screening and surveillance practices by gender.

Significantly lower annual rates of neoplastic progression in short- compared to long-segment non-dysplastic Barrett’s esophagus: a systematic review and meta-analysis

Endoscopy ◽  
2019 ◽  
Vol 51 (07) ◽  
pp. 665-672 ◽  
Author(s):  
Viveksandeep Thoguluva Chandrasekar ◽  
Nour Hamade ◽  
Madhav Desai ◽  
Tarun Rai ◽  
Venkata Subhash Gorrepati ◽  
...  
Keyword(s):  
Systematic Review ◽  
Barrett’S Esophagus ◽  
Barrett's Esophagus ◽  
Meta Analysis ◽  
Significant Heterogeneity ◽  
Neoplastic Progression ◽  
Number Of Patients ◽  
The Mean ◽  
Surveillance Endoscopy

Abstract Background Although shorter lengths of Barrett’s esophagus (BE) have been associated with a lower risk of neoplastic progression, precise estimates have varied, especially for non-dysplastic BE (NDBE) only. Therefore, current US guidelines do not provide specific recommendations on surveillance intervals based on BE length. We performed a systematic review and meta-analysis of the published literature to examine neoplastic progression rates of NDBE based on BE length. Methods PubMed, Cochrane, Google Scholar, and Embase were comprehensively searched. Studies reporting progression rates in patients with NDBE and > 1 year of follow-up were included. The number of patients progressing to esophageal adenocarcinoma (EAC) and high grade dysplasia (HGD)/EAC in individual studies and the mean follow-up were recorded to derive person-years of follow-up. Pooled rates of progression to EAC and HGD/EAC based on BE length (< 3 cm vs. ≥ 3 cm) were calculated. Results Of the 486 initial studies identified, 10 met the inclusion/exclusion criteria. These included a total of 4097 NDBE patients; 1979 with short-segment BE (SSBE; 10 773 person-years of follow-up) and 2118 with long-segment BE (LSBE; 12 868 person-years). The annual rates of progression to EAC were significantly lower for SSBE compared with LSBE: 0.06 % (95 % confidence interval 0.01 % – 0.10 %) vs. 0.31 % (0.21 % – 0.40 %), respectively; odds ratio (OR) 0.25 (0.11 – 0.56); P < 0.001, as were the rates for the combined endpoint (HGD/EAC): 0.24 % (0.09 % – 0.32 %) vs. 0.76 % (0.43 % – 0.89 %), respectively; OR 0.35 (0.21 – 0.58); P < 0.001. There was no significant heterogeneity among studies. Conclusion The results demonstrate significantly lower rates of neoplastic progression in NDBE patients with SSBE compared with LSBE. BE length can easily be used for risk stratification purposes for NDBE patients undergoing surveillance endoscopy and consideration should be given to tailoring surveillance intervals based on BE length in future US guidelines.

Fr162 GENDER DIFFERENCES IN BARRETT'S ESOPHAGUS AND IMPACT ON SCREENING AND SURVEILLANCE PRACTICES: A SYSTEMATIC REVIEW AND META-ANALYSIS

2021 ◽  
Vol 160 (6) ◽  
pp. S-243
Author(s):  
Nour Hamade ◽  
Inês Marques De Sá ◽  
Shanker Kundumadam ◽  
Kawthar Mohamed ◽  
Kevin Kennedy ◽  
...  
Keyword(s):  
Systematic Review ◽  
Gender Differences ◽  
Barrett’S Esophagus ◽  
Barrett's Esophagus ◽  
Meta Analysis ◽  
Screening And Surveillance

Tu1127 - The Risk of Neoplastic Progression Associated with Aberrant Immunostaining for P53 in Barrett's Esophagus: Systematic Review and Meta-Analysis

2018 ◽  
Vol 154 (6) ◽  
pp. S-900-S-901
Author(s):  
Patrick Snyder ◽  
Kerry B. Dunbar ◽  
Daisha Cipher ◽  
Rhonda F. Souza ◽  
Stuart J. Spechler ◽  
...  
Keyword(s):  
Systematic Review ◽  
Barrett’S Esophagus ◽  
Barrett's Esophagus ◽  
Meta Analysis ◽  
Neoplastic Progression

Post Endoscopy Barrett’s Neoplasia (PEBN) After A Negative Index Endoscopy: A Systematic Review & Proposal For Definitions and Performance Measures in Endoscopy

Endoscopy ◽  
2022 ◽  
Author(s):  
Madhav Desai ◽  
David A Lieberman ◽  
Sachin Srinivasan ◽  
Venkat Nutalapati ◽  
Abhishek Challa ◽  
...  
Keyword(s):  
Systematic Review ◽  
Barrett’S Esophagus ◽  
Barrett's Esophagus ◽  
Meta Analysis ◽  
Incidence Rates ◽  
High Rate ◽  
Negative Index ◽  
Inclusion Criteria ◽  
Surveillance Interval ◽  
And Performance

Background and aims: A high rate of neoplasia (high grade dysplasia; HGD and esophageal adenocarcinoma; EAC) has been reported in Barrett’s Esophagus at index endoscopy but precise rates of post endoscopy Barrett’s neoplasia (PEBN) are unknown. Methods: Systematic review and meta-analysis was performed examining electronic databases (inception to October 2021) for studies reporting PEBN. Consistent with definitions of Post Colonoscopy Colorectal Cancer as proposed by the World Endoscopy Organization, we defined neoplasia(HGD/EAC) detected at index endoscopy and/or within 6 months of a negative index endoscopy as “prevalent” neoplasia; those detected after 6 months of a negative index endoscopy and prior to next surveillance interval(i.e. 3 years) as PEBN or “interval” neoplasia, and those detected after 36 months of a negative index endoscopy as “incident” neoplasia. Pooled incidence rates and proportion relative to total neoplasia were analyzed. Results: 11 studies (n=59,795, age:62.3±3.3 years, 61%males) met inclusion criteria. The pooled incidence rates were: prevalent neoplasia 4.5% (95%confidence interval: 2.2-8.9) at baseline and additional 0.3%(0.1-0.7) within first 6 months, PEBN 0.52%(0.48-0.58) and incident neoplasia: 1.41%(0.93-2.14). At 3 years from index endoscopy, PEBN accounted for 3% while prevalent neoplasia accounted for 97% of total Barrett’s neoplasia. Conclusion: Neoplasia detected at or within 6 months of index endoscopy account for most of the Barrett’s neoplasia(>90%). Post-Endoscopy Barrett’s Neoplasia account for ~3% of cases and can be used for validation in future. This highlights the importance of a high-quality index endoscopy in Barrett’s Esophagus and the need to establish quality benchmarks to measure endoscopists’ performance.

Correction: Prevalence of Barrett’s esophagus in obese patients undergoing pre-bariatric surgery evaluation: a systematic review and meta-analysis

Endoscopy ◽  
2020 ◽  
Vol 52 (07) ◽  
pp. C8-C8
Author(s):  
Bashar Qumseya ◽  
Sherif Gendy ◽  
Alexander Wallace ◽  
Dennis Yang ◽  
Davis Estores ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bariatric Surgery ◽  
Barrett’S Esophagus ◽  
Barrett's Esophagus ◽  
Meta Analysis ◽  
Obese Patients
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