Barrett's metaplasia and colonic neoplasms: a significant association in a 203,534-patient study.
OBJECTIVE
The presence of an association between Barrett's metaplasia and colonic neoplasia has remained controversial. The aim of the study was to test the presence of this association, using a large national database.


METHODS
From a computerized database of surgical pathology reports, we selected 203,000 subjects who underwent colonoscopy and esophago-gastro-duodenoscopy with biopsy results available from both procedures. In a case-control study we compared the occurrence of Barrett's metaplasia in patients with and without various types of colonic neoplasms.


RESULTS
Barrett's metaplasia occurred more frequently among patients with hyperplastic polyps (OR = 2.14, 95 % CI 2.02-2.27), adenomatous polyps (2.52, 2.41-2.64), advanced adenomas (2.10, 1.90-2.32), villous adenomas or adenomas with high-grade (HG) dysplasia (2.45, 2.28-2.64), and colonic adenocarcinomas (1.75, 1.39-2.22). The association between Barrett's metaplasia and colonic neoplasm applied similarly to polyps of different size, number and location within the large bowel. These types of association could also be confirmed when analyzed separately for Barrett's metaplasia characterized by low-grade or HG dysplasia, as well as esophageal adenocarcinoma.


CONCLUSIONS
The data support the existence of a true association between Barrett's metaplasia and various types of colonic neoplasm. The association may be more interesting for its potential insights into the pathogenesis of the two disorders than its actual clinical implications.
Gastroenterology, Portland VA Medical Center P3-GI, 3710 SW US Veterans Hospital Road, Portland, OR 97239, USA. sonnenbe@ohsu.edu
Amnon
A
Sonnenberg
Robert M
RM
Genta
D000230:Adenocarcinoma / Q000150:complications*; D000236:Adenoma / Q000150:complications*; D000328:Adult; D000368:Aged; D001471:Barrett Esophagus / Q000209:etiology*; D016022:Case-Control Studies; D003110:Colonic Neoplasms / Q000150:complications*; D003111:Colonic Polyps / Q000150:complications*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012306:Risk