title: Higher prevalence of colon polyps in patients with Barrett's esophagus: a case-control study.
abstract: OBJECTIVE
  Barrett's esophagus (BE) and colorectal neoplasms share similar risk factors. Previous studies have shown variable prevalence of colon polyps in patients with BE. Our aims were to determine the prevalence and incidence of colon polyps in patients with BE, compared to those without BE.
  
  
  METHODS
  In this case-control study, the study group included patients, aged 50-75 years, with biopsy-proven BE, who underwent colonoscopy at Cleveland Clinic from January 2002 to December 2011. The control group consisted of age- and sex-matched patients who underwent colonoscopy and also an endoscopy with no evidence of BE during the same time period. Exclusion criteria for both groups were family- or personal previous history of colon cancer or polyps, prior colonic resection, inflammatory bowel disease and familial polyposis syndromes. Patient demographics, comorbidities, medication use and endoscopic and colonoscopic details were collected, including biopsy results.
  
  
  RESULTS
  A total of 519 patients were included in the study; 173 patients with BE in the study group and 346 without BE in the control group. Mean age at index colonoscopy was 61 ± 8 years and 75% of patients were male. On index colonoscopy, patients with BE were more likely to have polyps than controls (45% vs 32%, respectively; P = 0.003). Patients underwent between one and five colonoscopies during the follow-up. On multivariate analysis-after adjusting for age, gender and diabetes-patients with BE were 80% more likely to have any type of polyp, and 50% more likely to have adenomas found during colonoscopy.
  
  
  CONCLUSIONS
  Patients with BE had higher prevalence and incidence of colon polyps. This has important clinical implications for screening and surveillance in BE patients.
authors.affiliation: Center of Excellence for Barrett's Esophagus, Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio, USA and Department of Biostatistics, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Arthi
authors.initials: A
authors.lastname: Kumaravel
authors.affiliation: Center of Excellence for Barrett's Esophagus, Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio, USA and Department of Biostatistics, Cleveland Clinic, Cleveland, Ohio, USA thotap@ccf.org.
authors.forename: Prashanthi N
authors.initials: PN
authors.lastname: Thota
authors.affiliation: Center of Excellence for Barrett's Esophagus, Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio, USA and Department of Biostatistics, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Hyun-Ju
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: Center of Excellence for Barrett's Esophagus, Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio, USA and Department of Biostatistics, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Tushar
authors.initials: T
authors.lastname: Gohel
authors.affiliation: Center of Excellence for Barrett's Esophagus, Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio, USA and Department of Biostatistics, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Mehulkumar K
authors.initials: MK
authors.lastname: Kanadiya
authors.affiliation: Center of Excellence for Barrett's Esophagus, Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio, USA and Department of Biostatistics, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Rocio
authors.initials: R
authors.lastname: Lopez
authors.affiliation: Center of Excellence for Barrett's Esophagus, Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio, USA and Department of Biostatistics, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Madhusudhan R
authors.initials: MR
authors.lastname: Sanaka
keywords: Barrett’s esophagus; cancer prevention; colon polyps
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