title: Risk factors for the development of esophageal adenocarcinoma in Barrett's esophagus.
abstract: OBJECTIVE
  To identify risk factors for esophageal adenocarcinoma (EAC) in patients with Barrett's esophagus (BE).
  
  
  METHODS
  A hospital-based case-control study was performed in which 91 cases with EAC and 244 controls with histologically confirmed BE (>2 cm) with no dysplasia or low-grade dysplasia were included. Information on demographic, anthropometric, and lifestyle characteristics, physical activity levels, working posture, family history, gastroesophageal reflux disease (GERD) symptoms, and medication use was collected by questionnaire.
  
  
  RESULTS
  Cases more often were current smokers (odds ratio 3.7, 95% confidence interval 1.4-9.9), more often had a body mass index >25 assessed at age 20 (2.6, 1.2-5.5), and more frequently had been working in a stooped posture at age 20 (2.0, 1.1-3.9), compared to controls. In addition, cases less often experienced symptoms of heartburn (0.3, 0.2-0.5) and less frequently used proton pump inhibitors (0.1, 0.05-0.2), compared to controls, whereas use of nonsteroidal anti-inflammatory drugs/aspirin was more common among cases (1.8, 1.1-3.2). Cases more often were men, compared to controls (91%vs 67%, p < 0.001).
  
  
  CONCLUSIONS
  In patients with BE, the risk of EAC is related to risk factors for GERD, which is, however, asymptomatic. As these risk factors are common in Western countries, they are probably not helpful in individualization of surveillance intervals.
authors.affiliation: Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: Pieter J F
authors.initials: PJ
authors.lastname: de Jonge
authors.forename: Ewout W
authors.initials: EW
authors.lastname: Steyerberg
authors.forename: Ernst J
authors.initials: EJ
authors.lastname: Kuipers
authors.forename: Pieter
authors.initials: P
authors.lastname: Honkoop
authors.forename: Leonieke M M
authors.initials: LM
authors.lastname: Wolters
authors.forename: Marjon
authors.initials: M
authors.lastname: Kerkhof
authors.forename: Horman
authors.initials: H
authors.lastname: van Dekken
authors.forename: Peter D
authors.initials: PD
authors.lastname: Siersema
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology / Q000473:pathology*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D000897:Anti-Ulcer Agents / Q000008:administration & dosage; D001471:Barrett Esophagus / Q000453:epidemiology / Q000473:pathology*; D015992:Body Mass Index; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D004522:Educational Status; D004938:Esophageal Neoplasms / Q000453:epidemiology / Q000473:pathology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011187:Posture; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D011795:Surveys and Questionnaires
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000897:Anti-Ulcer Agents