title: Risk of oesophageal adenocarcinoma in individuals with Barrett's oesophagus.
abstract: Recent studies have indicated a lower incidence rate of oesophageal adenocarcinoma (OAC) in individuals with Barrett's oesophagus (BO) than most earlier studies. Our objective was to assess the risk of OAC in a Swedish unselected cohort of individuals with BO.
  
  
  
  This population-based cohort study included all Swedish residents diagnosed with BO in 2006-2013, identified through the Swedish Patient Registry. The cohort members were followed from the date of first BO diagnosis until the first occurrence of OAC, high-grade dysplasia (HGD), death, emigration or end of study period. The main outcome was incidence rates with 95% confidence intervals (CIs) of OAC.
  
  
  
  Among 7932 participants with BO and 18,415 person-years of follow-up, the overall incidence of OAC was 1.47 (95% CI 0.91-2.02) per 1000 person-years. When stratified into follow-up periods after BO diagnosis, the incidence rate of OAC was 15.53 (4.77-26.29) from 7 to 30 d, 4.10 (0.82-7.38) from 31 to 100 d, 1.87 (0.00-3.99) from 101 d to 6 months, 1.44 (0.18-2.70) from >6 months to 1 year, 0.94 (0.36-1.53) from >1 year to 3 years and 2.17 (1.14-3.21) from >3 years to the end of follow-up. The median follow-up time was 2.13 person-years.
  
  
  
  This population-based study indicates that OAC is primarily diagnosed during the first months following an initial diagnosis of BO. This could justify a changed surveillance strategy of BO with a repeated thorough endoscopy shortly after initial BO diagnosis to identify prevalent early OAC or HGD.
authors.affiliation: Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Solna, NS 67, 171 76 Stockholm, Sweden. Electronic address: dag.holmberg@ki.se.
authors.forename: Dag
authors.initials: D
authors.lastname: Holmberg
authors.affiliation: Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Solna, NS 67, 171 76 Stockholm, Sweden. Electronic address: eivind.ness-jensen@ki.se.
authors.forename: Eivind
authors.initials: E
authors.lastname: Ness-Jensen
authors.affiliation: Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Solna, NS 67, 171 76 Stockholm, Sweden. Electronic address: fredrik.mattsson@ki.se.
authors.forename: Fredrik
authors.initials: F
authors.lastname: Mattsson
authors.affiliation: Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA. Electronic address: hasheme@bcm.edu.
authors.forename: Hashem B
authors.initials: HB
authors.lastname: El-Serag
authors.affiliation: Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Solna, NS 67, 171 76 Stockholm, Sweden; Division of Cancer Studies, King's College London, Guy's Campus, London SE1 1UL, UK. Electronic address: jesper.lagergren@ki.se.
authors.forename: Jesper
authors.initials: J
authors.lastname: Lagergren
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000453:epidemiology*; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001471:Barrett Esophagus / Q000453:epidemiology*; D015331:Cohort Studies; D055088:Early Detection of Cancer; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000175:diagnosis / Q000453:epidemiology; D012307:Risk Factors; D017678:Sex Distribution; D013548:Sweden / Q000453:epidemiology
keywords: Barrett's oesophagus; High-grade dysplasia; Oesophageal adenocarcinoma; Oesophageal neoplasm; Surveillance