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News

Prediction of Barrett's esophagus among men

A study in this month's issue of the American Journal of Gastroenterology identifies predictors of Barrett's esophagus among men.

News image

Risk factors for Barrett's esophagus include gastroesophageal reflux disease (GERD) symptoms, age, abdominal obesity, and tobacco use.

Dr Joel Rubenstein and colleagues developed a tool using these factors to predict the presence of Barrett's esophagus.

The researchers recruited male colorectal cancer screenees to undergo upper endoscopy, identifying newly diagnosed cases of Barrett's esophagus.

Logistic regression models predicting Barrett's esophagus using gastroesophageal reflux disease symptoms alone and together with abdominal obesity, tobacco use, and age were compared.

The research team found Barrett's esophagus in 70 of 822 colorectal cancer screenees.

A model including 4 factors had a net reclassification improvement index of 19–25%
American Journal of Gastroenterology

Mutually adjusting for other covariates, Barrett's esophagus was associated with weekly gastroesophageal reflux disease, age, waist-to-hip ratio and pack-years of cigarette use.

The doctors examined that a model including those 4 factors had a greater area under the receiver operating characteristics curve than did a model based on gastroesophageal reflux disease frequency and duration alone, and it had a net reclassification improvement index of 19–25%.

Dr Rubenstein and colleagues concludes, "The prevalence of Barrett's esophagus was substantial in our population of older overweight men."

"A model based on gastroesophageal reflux disease, age, abdominal obesity, and cigarette use more accurately classified the presence of Barrett's esophagus than did a model based on gastroesophageal reflux disease alone."

"Following validation of the tool in another population, its use in clinical practice might improve the efficiency of screening for Barrett's esophagus."

Am J Gastroenterol 2013; 108: 353–3626
18 March 2013

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