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Women Seem to Have Low Risk of Barrett’s Esophagus Progression to Neoplasia, Study Finds

According to a multicenter study that women seem to have a significantly lower risk of progression from Barrett’s Esophagus (BE) to cancer and high-grade dysplasia (HGD).

Photo: An X-Ray of the Esophagus | InStyleHealth

What is Barrett’s Esophagus?

Barrett's esophagus is a medical condition in which the flat pink lining of the swallowing tube that connects the mouth to the stomach (esophagus) becomes damaged by acid reflux, this damage causes the lining to thicken or swollen and become red.

Researchers collected data from a large group of patients with BE seen at six centers in the US and Europe, and were monitored for an average 5.7 years. Data on demographics (e.g., age, gender, ethnicity), clinical history (tobacco use, body mass index, comorbidities), endoscopy results (procedure date, BE segment length), and histopathology results were then obtained.

Neoplasia was categorized as low-grade dysplasia, HGD, or esophageal adenocarcinoma (EAC). Experts then compared the rates of disease progression between men and women using χ2 analysis and the Student t test. Researchers also used multivariable logistic regression to examine the relationship between gender and disease progression after adjusting for possible independent variables.

Out of the 2,145 patients who met the eligibility criteria, 324 (15%) were women. There were 34 (1.6%) incident EACs recorded, with a total annual incidence of 0.3%.

Researchers also observed the significant differences between men and women in terms of annual incidence rates of EAC, where 0.03% in men vs 0.05% in women, and in the combined endpoint of HGD or EAC (1.10% in men vs 0.1% in women).

The female gender was independently correlated with reduced progression to HGD or EAC when rates of progression were adjusted for BMI, smoking history, ethnicity, aspirin use, nonsteroidal anti-inflammatory drugs (NSAIDs), proton-pump inhibitors, or statins, hypertriglyceridemia, BE length, and histology findings at baseline.

Researchers said that, “The extremely low risk of EAC in women with BE at 0.05% per year, indicates that surveillance endoscopy may not be necessary for this subgroup of patients with BE.”

For complete details of this study, click here.


Source: J Clin Gastroenterol 2021;55:321-326

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