Document Detail


Prediction of Barrett's esophagus among men.
MedLine Citation:
PMID:  23318485     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Risk factors for Barrett's esophagus include gastroesophageal reflux disease (GERD) symptoms, age, abdominal obesity, and tobacco use. We aimed to develop a tool using these factors to predict the presence of Barrett's esophagus.
METHODS: Male colorectal cancer (CRC) screenees were recruited to undergo upper endoscopy, identifying newly diagnosed cases of Barrett's esophagus. Logistic regression models predicting Barrett's esophagus using GERD symptoms alone and together with abdominal obesity, tobacco use, and age were compared.
RESULTS: Barrett's esophagus was found in 70 (8.5%) of 822 CRC screenees. Mutually adjusting for other covariates, Barrett's esophagus was associated with weekly GERD (odds ratio (OR)=2.33, 95% confidence interval (CI)=1.34, 4.05), age (OR per 10 years=1.53, 95% CI=1.05, 2.25), waist-to-hip ratio (OR per 0.10=1.44, 95% CI=0.898, 2.32) and pack-years of cigarette use (OR per 10 pack-years=1.09, 95% CI=1.04, 1.14). A model including those four factors had a greater area under the receiver operating characteristics curve than did a model based on GERD frequency and duration alone (0.72 vs. 0.61, P<0.001), and it had a net reclassification improvement index of 19-25%.
CONCLUSIONS: The prevalence of Barrett's esophagus was substantial in our population of older overweight men. A model based on GERD, age, abdominal obesity, and cigarette use more accurately classified the presence of Barrett's esophagus than did a model based on GERD alone. Following validation of the tool in another population, its use in clinical practice might improve the efficiency of screening for Barrett's esophagus.
Authors:
Joel H Rubenstein; Hal Morgenstern; Henry Appelman; James Scheiman; Philip Schoenfeld; Laurence F McMahon; Valbona Metko; Ellen Near; Joan Kellenberg; Tal Kalish; John M Inadomi
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2013-01-15
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  108     ISSN:  1572-0241     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-03-05     Completed Date:  2013-05-20     Revised Date:  2014-06-25    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  353-62     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Barrett Esophagus / diagnosis*,  etiology
Cross-Sectional Studies
Gastroesophageal Reflux / complications*
Humans
Logistic Models
Male
Middle Aged
Obesity, Abdominal / complications*
Predictive Value of Tests
Risk Factors
Smoking / adverse effects*
Waist-Hip Ratio
Grant Support
ID/Acronym/Agency:
K23 DK079291/DK/NIDDK NIH HHS; K23DK079291/DK/NIDDK NIH HHS; K24 DK080941/DK/NIDDK NIH HHS; K24 DK084208/DK/NIDDK NIH HHS; K24DK080941/DK/NIDDK NIH HHS; K24DK084208/DK/NIDDK NIH HHS; T32 DK062708/DK/NIDDK NIH HHS
Comments/Corrections
Comment In:
Am J Gastroenterol. 2013 Mar;108(3):363-5   [PMID:  23459045 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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