title: Barrett's oesophagus length is established at the time of initial endoscopy and does not change over time: results from a large multicentre cohort.
abstract: OBJECTIVE
  It is unclear whether Barrett's oesophagus (BO) length changes over time or whether the full length of the segment is established at the onset of disease recognition. The objectives of this study were to evaluate the association of age and BO length and to evaluate the changes in BO length over time.
  
  
  METHODS
  This is a prospective, multicentre cohort study involving patients with BO from five centres. Patients were divided into groups based on the decade of initial diagnosis of BO. The mean BO length and the mean change in BO length were calculated for each age decade. The mean change in BO length was also calculated between the index endoscopy and the last surveillance endoscopy.
  
  
  RESULTS
  3635 patients with BO were included in the study: 87.8% men, 92.8% Caucasians, mean age 60.9 years and mean BO length 3.5 cm. The mean change in BO length was 0.9 cm. The mean BO length did not significantly change for each age category: <30 years (4.6 cm), 30-39.9 years (3.2 cm), 40-49.9 years (3.1 cm), 50-59.9 years (3.1 cm), 60-69.9 years (3.6 cm), 70-79.7 (4.0 cm) and >80 years (4.5 cm), p=0.47. On subgroup analysis of patients with non-dysplastic BO who had at least 1 year of endoscopic follow up, there was a significant decrease in mean change in BO length across age categories ranging from +1.7 to -0.8 cm, p=0.03.
  
  
  CONCLUSIONS
  There was no significant difference in BO length by age category in decades. In addition, the change in BO length from index to follow-up endoscopy was similar among patients >30 years. These findings suggest that a patient's BO segment length attains its full extent by the time of the initial endoscopic examination.
authors: Gastroenterology Service, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.
authors: Fouad J
authors: FJ
authors: Moawad
authors: Gastroenterology Service, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.
authors: Patrick E
authors: PE
authors: Young
authors: Gastroenterology Division, Washington University in St Louis, St Louis, Missouri, USA.
authors: Srinivas
authors: S
authors: Gaddam
authors: Division of Gastroenterology, Kansas City Veterans Affairs Medical Center, Kansas City, Missouri, USA.
authors: Prashanth
authors: P
authors: Vennalaganti
authors: Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio, USA.
authors: Prashanthi N
authors: PN
authors: Thota
authors: Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio, USA.
authors: John
authors: J
authors: Vargo
authors: Division of Gastroenterology, University of South Alabama, Mobile, Alabama, USA.
authors: Brooks D
authors: BD
authors: Cash
authors: Division of Gastroenterology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
authors: Gary W
authors: GW
authors: Falk
authors: Division of Gastroenterology and Hepatology, University of Arizona, Tucson, Arizona, USA.
authors: Richard E
authors: RE
authors: Sampliner
authors: Division of Gastroenterology and Hepatology, Oregon Health & Sciences University, Portland, Oregon, USA.
authors: David
authors: D
authors: Lieberman
authors: Division of Gastroenterology, Kansas City Veterans Affairs Medical Center, Kansas City, Missouri, USA Division of Gastroenterology and Hepatology, University of Kansas School of Medicine, Kansas City, Kansas, USA.
authors: Prateek
authors: P
authors: Sharma
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001471:Barrett Esophagus / Q000473:pathology*; D004945:Esophagoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors
keywords: ACID-RELATED DISEASES; BARRETT'S CARCINOMA; BARRETT'S METAPLASIA; BARRETT'S OESOPHAGUS