title: Comparison of endoscopic and clinical characteristics of patients with familial and sporadic Barrett's esophagus.
abstract: BACKGROUND
  A proportion of Barrett's esophagus (BE) and esophageal adenocarcinoma (EAC) displays familial aggregation, known as familial Barrett's esophagus (FBE). Pedigrees and characteristics of EAC in these families have been previously described.
  
  
  OBJECTIVE
  We aimed to evaluate endoscopic and clinical characteristics of Barrett's esophagus in FBE.
  
  
  METHODS
  A cohort of 979 BE patients were retrospectively evaluated for FBE, defined as having a first-degree relative with BE or esophageal cancer, confirmed when possible by interview. FBE and sporadic BE were compared regarding demographic, clinical, and endoscopic characteristics. Potential FBE probands were contacted and interviewed to obtain full family pedigrees.
  
  
  RESULTS
  Of 603 BE probands (61.6% of total cohort) with a documented family history, 35 (5.8%) had FBE. There was no difference between FBE and non-FBE probands with regard to BE length (median: 3 cm, IQR 2-5 vs. 3 cm, IQR 1-6 cm, respectively; p = 0.78) or hiatal hernia size (p = 0.90). FBE probands were younger (mean, 58.4 vs. 63.8; p = 0.02) and had a significant association with less-advanced neoplasia (adjusted OR 0.41, 95% CI 0.19-0.90). There was no obvious association between FBE and other malignancies.
  
  
  CONCLUSIONS
  There were no differences in endoscopic characteristics between FBE and non-FBE probands. While FBE patients were younger and had less-advanced neoplasia, we speculate that these findings may have been the result of more aggressive screening due to the family history. Further studies are warranted to determine whether familial clustering is due to genetic predisposition to development of BE or to risk of neoplastic progression.
authors.affiliation: Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA.
authors.forename: Samuel
authors.initials: S
authors.lastname: Ash
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Vaccaro
authors.forename: Mary Kay
authors.initials: MK
authors.lastname: Dabney
authors.forename: Wendy K
authors.initials: WK
authors.lastname: Chung
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Lightdale
authors.forename: Julian A
authors.initials: JA
authors.lastname: Abrams
mesh_terms: D000230:Adenocarcinoma / Q000209:etiology* / Q000235:genetics / Q000473:pathology; D000368:Aged; D001471:Barrett Esophagus / Q000150:complications* / Q000235:genetics* / Q000473:pathology; D015331:Cohort Studies; D004938:Esophageal Neoplasms / Q000209:etiology* / Q000235:genetics / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010375:Pedigree; D012307:Risk Factors