February 12, 2019

Family history

Investigators from Thomas Jefferson University estimate more than a five-fold increased risk of developing esophageal adenocarcinoma in persons with Barrett's who have a first-degree relative with Barrett's.

Family history

United European Gastroenterology Journal

Christina J Tofani,  Kunjal Gandhi,  Joseph Spataro, et al.

Abstract

Background

The  significance of a family history of esophageal adenocarcinoma in the  progression to esophageal adenocarcinoma in patients with Barrett’s  esophagus has not been thoroughly evaluated. The purpose of this study  is to evaluate the presence of esophageal adenocarcinoma in a  first-degree relative in patients with Barrett’s esophagus.

Methods

A  retrospective cohort study was conducted of patients with Barrett’s  esophagus at a tertiary care center undergoing radiofrequency ablation.  Family history, demographics, and pathology and endoscopy reports were  assessed in all patients.

Findings

Three  hundred and one patients with Barrett’s esophagus were assessed.  Nineteen patients who had a diagnosis of esophageal adenocarcinoma on  index endoscopy were excluded. Nineteen (6.7%) patients had a  first-degree relative with esophageal adenocarcinoma. Four (21.1%) of  these patients progressed to esophageal adenocarcinoma. Of patients  without first-degree relative with esophageal adenocarcinoma 22/263  (8.7%) progressed to esophageal adenocarcinoma. In a logistic regression  model adjusted for sex and the number of radiofrequency ablation  treatments, we found that family history of esophageal adenocarcinoma  was a significant independent predictor of progression to esophageal  adenocarcinoma (odds ratio = 5.55, 95% confidence interval: 1.47–20.0).

Conclusion

Our  study indicates that Barrett’s esophagus patients with a first-degree  family member with esophageal adenocarcinoma are at 5.5-fold higher risk  for disease progression to esophageal adenocarcinoma. Family history of  esophageal adenocarcinoma in Barrett’s esophagus patients should be  considered in patient surveillance and radiofrequency ablation  treatment, beyond recommended guidelines.

Investigators from Thomas Jefferson University estimate more than a five-fold increased risk of developing esophageal adenocarcinoma in persons with Barrett's who have a first-degree relative with Barrett's.