Cancer risk by length of Barrett's esophagus in Japanese population: a nationwide multicenter retrospective cohort study.

IF 6.9 2区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Journal of Gastroenterology Pub Date : 2024-10-01 Epub Date: 2024-08-16 DOI:10.1007/s00535-024-02139-2
Sho Fukuda, Kenta Watanabe, Dai Kubota, Nobutake Yamamichi, Yu Takahashi, Yoshitaka Watanabe, Kyoichi Adachi, Norihisa Ishimura, Tomoyuki Koike, Hideyuki Sugawara, Kiyotaka Asanuma, Yasuhiko Abe, Takashi Kon, Eikichi Ihara, Kazuhiro Haraguchi, Yoshihiro Otsuka, Rie Yoshimura, Yugo Iwaya, Takuma Okamura, Noriaki Manabe, Akira Horiuchi, Mio Matsumoto, Kengo Onochi, So Takahashi, Tatsuki Yoshida, Yosuke Shimodaira, Katsunori Iijima
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Abstract

Background: The cancer risk for each length of Barrett's esophagus (BE) in Japanese is unknown. This nationwide, multi-institutional study aims to clarify the cancer risk by length of BE in the general Japanese population.

Methods: Consecutive subjects who underwent upper endoscopic screening at 17 centers between 2013 and 2017 and had at least one follow-up endoscopy by December 2022 were included. The presence/absence of BE and, if present, its length were retrospectively assessed using the retrieved endoscopic images recorded at baseline. Information on the subsequent occurrence of esophageal adenocarcinoma and other upper gastrointestinal cancers was also collected. Cancer incidence was calculated and expressed as %/year.

Results: A total of 33,478 subjects were enrolled, and 17,884 (53.4%), 10,641 (31.8%), 4889 (14.6%), and 64 (0.2%) were diagnosed as absent BE, BE < 1 cm, 1-3 cm, and ≥ 3 cm, respectively. During a median follow-up of 80 months, 11 cases of esophageal adenocarcinoma developed. The annual incidence of esophageal adenocarcinoma is 0%/year for absent BE, 0.0032 (0.00066-0.013)%/year for BE < 1 cm, 0.026 (0.011-0.054)%/year for 1-3 cm, and 0.58 (0.042-2.11)%/year for ≥ 3 cm, respectively. Meanwhile, the incidence of esophageal squamous cell carcinoma and gastric cancer were 0.039 (0.031-0.049)%/year and 0.16 (0.14-0.18)%/year, respectively.

Conclusions: By enrolling a large number of subjects with long-term follow-up, this study demonstrated that the risk of cancer increased steadily with increasing length of BE in the Japanese population. Therefore, it is important to consider the length of BE when determining the management strategy for BE.

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日本人患癌症的风险与巴雷特食管长度有关:一项全国性多中心回顾性队列研究。
背景:日本人中不同长度的巴雷特食管(BE)的癌症风险尚不清楚。这项全国性、多机构研究旨在明确日本普通人群中不同长度的巴雷特食管的癌症风险:方法:纳入 2013 年至 2017 年期间在 17 个中心接受上消化道内镜筛查并在 2022 年 12 月前至少接受过一次随访内镜检查的连续受试者。通过检索基线时记录的内镜图像,回顾性评估是否存在BE以及BE的长度。此外,还收集了随后发生的食管腺癌和其他上消化道癌症的信息。癌症发病率以%/年的形式计算:共有 33,478 名受试者被纳入研究,其中 17,884 人(53.4%)、10,641 人(31.8%)、4889 人(14.6%)和 64 人(0.2%)被诊断为无 BE、BE 结论:通过对大量受试者进行长期随访,本研究表明,在日本人群中,癌症风险随着BE时间的延长而稳步上升。因此,在确定 BE 的治疗策略时,必须考虑 BE 的持续时间。
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来源期刊
Journal of Gastroenterology
Journal of Gastroenterology 医学-胃肠肝病学
CiteScore
12.20
自引率
1.60%
发文量
99
审稿时长
4-8 weeks
期刊介绍: The Journal of Gastroenterology, which is the official publication of the Japanese Society of Gastroenterology, publishes Original Articles (Alimentary Tract/Liver, Pancreas, and Biliary Tract), Review Articles, Letters to the Editors and other articles on all aspects of the field of gastroenterology. Significant contributions relating to basic research, theory, and practice are welcomed. These publications are designed to disseminate knowledge in this field to a worldwide audience, and accordingly, its editorial board has an international membership.
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