Multicentre prospective controlled study of Barrett's oesophagus and colorectal adenomas. Groupe d'Etude de l'Oesophage de Barrett

Lancet. 1995 Nov 25;346(8987):1391-4. doi: 10.1016/s0140-6736(95)92406-x.


Previous studies have suggested that patients with Barrett's oesophagus may be at increased risk of colorectal neoplasia, though the association is disputed. In a multicentre prospective study we compared the prevalence of colorectal adenomas in patients with Barrett's oesophagus and controls. Barrett's oesophagus patients (n = 104) had histological confirmation of columnar epithelium extending more than 3 cm above the gastro-oesophageal junction. The 537 controls were patients with symptoms suggesting irritable bowel syndrome. No participant had a personal history of colonic neoplasm. Each patient underwent colonoscopy. Histologically proven adenomas were found in 26 Barrett's patients (25%) and 75 controls (14%). Three colorectal cancers were discovered in each group. The prevalence of adenomas was greater in the Barrett's oesophagus group than in the control group (p < 0.01) but the relation became non-significant after adjustment for age and sex and control for other known risk factors by a logistic regression model (odds ratio 1.4 [0.7-2.7]). The relative risk of adenoma was significantly higher in patients older than 59 than in younger patients (2.2 [1.3-3.5]) and in men than in women (3.4 [2.0-5.7]). Other factors contributing significantly to the risk of adenoma were a family history of colorectal cancer (2.3 [1.1-4.8]), rectal bleeding (2.1 [1.1-3.9]), previous colonic investigation (0.3 [0.1-0.7]), and complete as opposed to partial colonoscopy (6.4 [0.8-48.3]). We conclude that Barrett's oesophagus is not an independent risk factor for colorectal neoplasia and, therefore, is not, in itself an indication for colorectal screening.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenoma / epidemiology
  • Adenoma / etiology*
  • Adenoma / pathology
  • Adult
  • Aged
  • Aged, 80 and over
  • Barrett Esophagus / complications*
  • Barrett Esophagus / pathology
  • Colonic Neoplasms / epidemiology
  • Colonic Neoplasms / etiology*
  • Colonic Neoplasms / genetics
  • Colonic Neoplasms / pathology
  • Endoscopy, Gastrointestinal
  • Female
  • Gastrointestinal Hemorrhage / complications
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Prevalence
  • Prospective Studies
  • Rectal Neoplasms / epidemiology
  • Rectal Neoplasms / etiology*
  • Rectal Neoplasms / genetics
  • Rectal Neoplasms / pathology
  • Rectum
  • Risk Factors