Risk factors for Barrett's esophagus : a scoping review

Introduction Cancer of the esophagus is a highly lethaldisease with many patients presenting with metastaticspread of their tumor at diagnosis; a consequence of thislate presentation is the 5-year survival rate of \20 %.Barrett’s esophagus (BE), a premalignant condition of thedistal esophagus, is the main risk factor for adenocarcinomaof the esophagus. The development of a risk predictiontool that could assist healthcare professionals inidentifying people at increased risk of developing BEwould be advantageous. Understanding the factors thatinfluence the risk of developing BE is the first stage ofdeveloping a risk prediction tool. Methods A scoping review was undertaken to address thefollowing question ‘what factors influence the risk ofdeveloping Barrett’s esophagus?’ Forty-six articles wereincluded in this review. Results The majority of articles reviewed were case–control or cohort studies. Samples sizes ranged from 68 to84,606. Risk factors reported to be statistically significantwere divided into three categories: demographic, lifestyleand clinical factors. Strongest risk factors identifiedinclude: male gender, increasing age, white race, smoking,obesity and gastro-esophageal reflux disease symptoms,while some aspects of a person’s diet appear to act as aprotective measure. Conclusion Risk factors for BE are complex and need tobe considered by healthcare professionals when identifyingpatients that could benefit from endoscopic eradication.These results provide a stepping stone for the futuredevelopment of a risk prediction model