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Mortality of people with Barrett's esophagus vs the general population

The latest issue of Gastroenterology investigates cause-specific mortality of people with Barrett's esophagus compared with the general population.

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Understanding the causes of death in people with Barrett's esophagus could guide evidence-based practice in the follow-up of these patients.

Dr Masoud Solaymani–Dodaran and colleagues from the United Kingdom identified individuals diagnosed with Barrett's esophagus in the UK's Clinical Practice Research Datalink, and linked their information with that from England's Hospital Episode Statistics database.

The research team reported that eligible patients were matched with individuals without Barrett's esophagus for age, sex, and general practice.

Causes of death were obtained from the UK's Office for National Statistics.

Absolute excess risks were calculated by subtracting cause-specific mortality values of controls from those of patients with Barrett's esophagus.

Compared with the control population, the team found that patients with Barrett's esophagus had increased risks of death from neoplasms and from respiratory and digestive causes but not from circulatory disorders.

The annual mortality rate from esophageal cancer among patients with Barrett's esophagus was 0.14%.

The team observed that 4.5% of deaths among these patients resulted from this cancer, leading to a cumulative 10-year risk of almost 2%.

4.5% of deaths among these patients resulted from esophageal cancer
Gastroenterology

The doctors found that the largest single cause of death among patients with Barrett's esophagus was ischemic heart disease.

The team noted that 168 patients with Barrett's esophagus died of this cause, nearly 4-fold the number that died of esophageal cancer.

Dr Solaymani–Dodaran's  team commented, "Among patients with Barrett's esophagus, approximately 2% will die of esophageal cancer within 10 years."

"However, patients with Barrett's esophagus died more frequently of other causes, such as ischemic heart disease."

"Evidence-based strategies are available to prevent this disease and might be more cost-effective for reducing mortality among patients with Barrett's esophagus."

Gastroenterol 2013:144(7) :1375-1383
28 June 2013

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