Rising incidence of esophageal adenocarcinoma in Western countries: is it possible to identify a population at risk?

Symptomatic gastroesophageal reflux disease (GERD) and Barrett's mucosa are risk factors for esophageal adenocarcinoma (ADC). The aim of this study wa s to analyze the anthropometric features and prevalence of GERD in patients with ADC compared with patients with squamous cell carcinoma (SCC) and con trol subjects. A total of 262 patients with ADC and 302 with SCC were enrol led consecutively. A control group of 262 individuals, sex and age matched to the ADC group, and an additional group of 138 patients with GERD confirm ed by 24-h pH monitoring were used for comparison. The prevalence of sympto matic GERD was 32.4% in the subgroup of patients with Barrett's ADC (male-f emale = 6.4:1; mean age = 62 years) vs. 8% in those with gastric cardia car cinoma (P < 0.01), 3% in the SCC group (P < 0.01), and 10% in the control g roup (P < 0.01). ADC patients, controls and refluxers had similar body mass index (BMI) that was significantly higher than in the SCC group (P < 0.05) . Whether surveillance endoscopy is indicated in men over 50 years with a l ong-lasting history of GERD and a BMI > 25 remains to be determined.