Gatenby, P.A.C.; Caygill, C.P.J.; Charlett, A.; Fitzgerald, R.; Watson, A.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA41
Academic Journal
Introduction: Studies have suggested a higher incidence of adenocarcinoma (AC) in longer Barrett's oesophagus (BO) segments, but this has not been stratified. Although AC has been described in short BO segments ≤3cm (SSB), its incidence is controversial. The influence of age, gender, smoking, alcohol, and BMI on the development of BO has been studied in small series, but not their influence on segment length. Methods: Medical records of 1000 BO patients from 5 hospitals registered with UKBOR were examined. Data were extracted on age, gender, BMI, tobacco, and alcohol use, and length of BO segment at BO diagnosis. Data on AC development were also abstracted. Segment lengths were categorised as SSB, >3 ≤6cm and >6cm. The relationships between demographic parameters and segment length, and segment length and AC development were determined, both for overall cancer risk and true incident cancers (occurring >1 year after BO diagnosis). Results: Histology and segment length were available in 625 records. There was a small non-significant increase in BO length with age, but no correlation between gender, BMI, tobacco and alcohol consumption and segment length. The distribution of the 28 overall and 9 incident ACs according to segment length is shown in the table. Conclusions: The risk of both overall and incident cancers is greater for SSB than for segments >3 ≤6cm in length, but the greatest risk is for length >6cm (Pearson χ² p=0.02). Whilst demographic factors have previously shown an influence on the risks of developing BO, there is little correlation with the length of segment which develops.


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