Although a recent study showed the cancer incidence of Barrett’s esophagus (BE) to be 1.2%/year in 251 patient-years in Japan, the long-term outcomes remain unclear. The present study estimated the cancer risk of BE in Japan using our original prospective multicenter cohort.
A total of 98 patients with BE of maximum length of ≥2 cm were enrolled during the period of 2010 to 2012 and received at least 1 follow-up endoscopy over 5 years thereafter. Cancer incidence rates with 95% confidence interval for occurrence of esophageal adenocarcinoma were calculated as the number of events divided by patient-years of follow-up and were expressed as %/year.
Overall, the median endoscopic follow-up period was 59.9 (first and third quartiles: 48.5-60.8) months, constituting a total of 427 patient-years of observation. Since 2 esophageal adenocarcinoma cases developed, the cancer incidence was 0.47% (0.01%-1.81%)/year. The cancer incidence was 0.39% (-0.16%-2.44%) in 232 patient-years and 0.31% (-0.13%-1.95%)/year in 318 patient-years for 55 cases with specialized intestinal metaplasia and 70 with BE ≥3 cm (maximum), respectively. At the end of follow-up, 12 of 92 patients (13.0%) died, but none died from esophageal adenocarcinoma.
This is the largest prospective follow-up study with endoscopy to investigate the incidence of esophageal adenocarcinoma in unequivocal BE with the maximum length of ≥2 cm in Japan. Although a further large-scale study will be required to validate our results, the cancer risk of BE in Japan would be lower than previously reported (0.47% vs. 1.2%/year).
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Kazuaki Norita
Tomoyuki Koike
Masahiro Saito
Hirohiko Shinkai H
Reiko Ami
Yasuhiko Abe
Naohiro Dairaku
Yoshifumi Inomata
Shoichi Kayaba
Fumitake Ishiyama
Tomoyuki Oikawa
Motoki Ohyauchi
Hirotaka Ito
Sho Asonuma
Tatsuya Hoshi
Katsuaki Kato
Shuichi Ohara
Yosuke Shimodaira
Kenta Watanabe
Tooru Shimosegawa
Atsushi Masamune
Katsunori Iijima
References
PubMed