title: Risk factors and chemoprevention in Barrett's esophagus--an update.
abstract: OBJECTIVE
  Barrett's esophagus (BO) is a precursor of esophageal adenocarcinoma (OAC), a cancer with a poor prognosis and an increasing incidence. Hence there is an interest in mapping causal factors underlying BO and finding strategies to reduce the risk of dysplasia progression in patients with BO. Here we review current knowledge on established as well as less risk factors for the development of BO. Additionally, we summarize today's status on the use of chemoprevention aiming to reduce the risk of cancer progression in BO patients.
  
  
  METHODS
  We searched Medline and the Cochrane Library using the MeSH terms "Barrett's esophagus" and "Barrett esophagus," both alone and combined with the terms "risk factor," "aetiology," "diet," or "prevention." Focus was on original contributions, systematic reviews, and meta-analyses.
  
  
  RESULTS
  Established risk factors for the development of BO include gastro-esophageal reflux, obesity, male gender, Caucasian ethnicity, and increasing age. Smoking might increase the risk of BO, while aspirin/NSAIDs, Helicobacter pylori infection, and specific "healthy" dietary factors may lower the risk. The potential value of using chemoprevention with proton pump inhibitors, aspirin/NSAIDs, or statins is still uncertain.
  
  
  CONCLUSIONS
  There is today a substantial knowledge of risk factors of BO. Certain diet may be protective of BO, albeit yet to be proven. The efficiency of chemoprevention in BO is currently addressed further in randomized clinical trials.
authors.affiliation: Department of Molecular Medicine and Surgery, Karolinska Institutet, Upper Gastrointestinal Research (UGIR), Stockholm, Sweden.
authors.forename: Hanna
authors.initials: H
authors.lastname: Winberg
authors.forename: Mats
authors.initials: M
authors.lastname: Lindblad
authors.forename: Jesper
authors.initials: J
authors.lastname: Lagergren
authors.forename: Hanna
authors.initials: H
authors.lastname: Dahlstrand
mesh_terms: D001471:Barrett Esophagus / Q000188:drug therapy / Q000517:prevention & control*; D018890:Chemoprevention; D005260:Female; D006801:Humans; D008297:Male; D012307:Risk Factors