title: Risk factors for the development of an adenocarcinoma in columnar-lined (Barrett) esophagus. The Rotterdam Esophageal Tumor Study Group.
abstract: BACKGROUND
  To evaluate the importance of the length of columnar-lined esophagus, sex, age, smoking, and drinking habits as risk factors for malignant degeneration, the authors performed a retrospective case-control study comparing patients with and without adenocarcinoma in Barrett esophagus.
  
  
  METHODS
  The records of 96 patients (53 male and 43 female; mean age, 61 years) with a benign columnar-lined esophagus and 62 patients (47 male and 15 female; mean age, 62 years) with an adenocarcinoma in columnar-lined esophagus referred to the Rotterdam Esophageal Tumor Study Group, diagnosed over the same period (1978-1985), were reviewed. A frequency distribution of the length of columnar-lined esophagus in both groups was made. Statistical analysis was performed with multivariate methods.
  
  
  RESULTS
  The length of columnar-lined esophagus was related significantly to carcinoma: a doubling of the length resulted in a 1.7 times increased risk. Smokers had a 2.3-fold increased risk as compared with nonsmokers. Male sex as a risk factor approached statistical significance (P = 0.06). Adjusted for these risk factors, no relation between carcinoma and age or alcohol consumption was found.
  
  
  CONCLUSIONS
  The risk of development of an adenocarcinoma in Barrett esophagus increased with the length of Barrett epithelium. Smoking and possibly male sex were also risk factors. The identification of these risk factors may help in developing more efficient screening programs for patients with Barrett esophagus.
authors.affiliation: Department of Surgery, University Hospital Rotterdam-Dijkzigt, The Netherlands.
authors.forename: M B
authors.initials: MB
authors.lastname: Menke-Pluymers
authors.forename: W C
authors.initials: WC
authors.lastname: Hop
authors.forename: J
authors.initials: J
authors.lastname: Dees
authors.forename: M
authors.initials: M
authors.lastname: van Blankenstein
authors.forename: H W
authors.initials: HW
authors.lastname: Tilanus
mesh_terms: D000230:Adenocarcinoma / Q000209:etiology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000009:adverse effects; D001471:Barrett Esophagus / Q000150:complications* / Q000473:pathology; D016022:Case-Control Studies; D004938:Esophageal Neoplasms / Q000209:etiology*; D004947:Esophagus / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects