title: Lifetime risk of esophageal adenocarcinoma in patients with Barrett's esophagus.
abstract: OBJECTIVE
  To investigate the lifetime risk of development of esophageal adenocarcinoma and/or high-grade dysplasia in patients diagnosed with Barrett's esophagus.
  
  
  METHODS
  Data were extracted from the United Kingdom National Barrett's Oesophagus Registry on date of diagnosis, patient age and gender of 7877 patients from who had been registered from 35 United Kingdom centers. Life expectancy was evaluated from United Kingdom National Statistics data based upon gender and age at year at diagnosis. These data were then used with published estimates of annual adenocarcinoma and high-grade dysplasia incidences from meta-analyses and large population-based studies to estimate overall lifetime risk of development of these study endpoints.
  
  
  RESULTS
  The mean age at diagnosis of Barrett's esophagus was 61.6 years in males and 67.3 years in females. The mean life expectancy at diagnosis was 23.1 years in males, 20.7 years in females and 22.2 years overall. Using data from published meta-analyses, the lifetime risk of development of adenocarcinoma was between 1 in 8 and 1 in 14 and the lifetime risk of high-grade dysplasia or adenocarcinoma was 1 in 5 to 1 in 6. Using data from 3 large recent population-based cohort studies the lifetime risk of adenocarcinoma was between 1 in 10 and 1 in 37 and of the combined end-point of high-grade dysplasia and adenocarcinoma was between 1 in 8 and 1 in 20. Age at Barrett's esophagus diagnosis is reducing and life expectancy is increasing, which will partially counter-balance lower annual cancer incidence.
  
  
  CONCLUSIONS
  There is a significant lifetime risk of development of high-grade dysplasia and adenocarcinoma in Barrett's esophagus.
authors: Piers Gatenby, Christine Caygill, Christine Wall, Santanu Bhatacharjee, James Ramus, Anthony Watson, Marc Winslet, Division of Surgery and Interventional Science, UCL, London, NW32QG, United Kingdom.
authors: Piers
authors: P
authors: Gatenby
authors: Piers Gatenby, Christine Caygill, Christine Wall, Santanu Bhatacharjee, James Ramus, Anthony Watson, Marc Winslet, Division of Surgery and Interventional Science, UCL, London, NW32QG, United Kingdom.
authors: Christine
authors: C
authors: Caygill
authors: Piers Gatenby, Christine Caygill, Christine Wall, Santanu Bhatacharjee, James Ramus, Anthony Watson, Marc Winslet, Division of Surgery and Interventional Science, UCL, London, NW32QG, United Kingdom.
authors: Christine
authors: C
authors: Wall
authors: Piers Gatenby, Christine Caygill, Christine Wall, Santanu Bhatacharjee, James Ramus, Anthony Watson, Marc Winslet, Division of Surgery and Interventional Science, UCL, London, NW32QG, United Kingdom.
authors: Santanu
authors: S
authors: Bhatacharjee
authors: Piers Gatenby, Christine Caygill, Christine Wall, Santanu Bhatacharjee, James Ramus, Anthony Watson, Marc Winslet, Division of Surgery and Interventional Science, UCL, London, NW32QG, United Kingdom.
authors: James
authors: J
authors: Ramus
authors: Piers Gatenby, Christine Caygill, Christine Wall, Santanu Bhatacharjee, James Ramus, Anthony Watson, Marc Winslet, Division of Surgery and Interventional Science, UCL, London, NW32QG, United Kingdom.
authors: Anthony
authors: A
authors: Watson
authors: Piers Gatenby, Christine Caygill, Christine Wall, Santanu Bhatacharjee, James Ramus, Anthony Watson, Marc Winslet, Division of Surgery and Interventional Science, UCL, London, NW32QG, United Kingdom.
authors: Marc
authors: M
authors: Winslet
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000453:epidemiology*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001471:Barrett Esophagus / Q000175:diagnosis / Q000453:epidemiology*; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008017:Life Expectancy; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D011230:Precancerous Conditions / Q000175:diagnosis / Q000453:epidemiology*; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology
keywords: Barrett esophagus; Cohort studies; Esophageal neoplasms; Forecasting; Meta-analysis