Systematic review with meta-analysis: prevalent vs. incident oesophageal adenocarcinoma and high-grade dysplasia in Barrett's oesophagus

K. Visrodia, S. Singh, R. Krishnamoorthi, D. A. Ahlquist, Kenneth Ke Ning Wang, Prasad G Iyer, David A Katzka

Research output: Contribution to journalReview article

9 Citations (Scopus)

Abstract

Background: The proportion of oesophageal adenocarcinoma that is detected concurrently with initial Barrett's oesophagus diagnosis is not well studied. Aim: To compare the proportion of prevalent adenocarcinoma vs. incident adenocarcinoma found during surveillance of Barrett's. Methods: We performed a systematic search of MEDLINE, EMBASE and Web of Science (from their inception to 31 May 2015) for cohort studies in adults with Barrett's (nondysplastic Barrett's ± Barrett's with low-grade dysplasia) with minimum average follow-up of 3 years, and providing numbers of prevalent adenocarcinoma detected (concurrently with Barrett's diagnosis and up to 1 year afterwards) vs. incident adenocarcinoma detected (greater than 1 year after Barrett's diagnosis). Pooled weighted proportions of prevalent and incident adenocarcinoma were calculated, using a random effects model. Results: On meta-analysis of 13 studies reporting on 603 adenocarcinomas in 9657 Barrett's patients, 85.1% of adenocarcinomas were classified as prevalent [95% confidence interval (CI), 78.1–90.2%) and 14.9% as incident (95% CI, 9.8–21.9%), with substantial heterogeneity (I2 = 66%). Among nine studies reporting on 787 high-grade dysplasia and oesophageal adenocarcinomas in 8098 Barrett's patients, the proportion of prevalent high-grade dysplasia-oesophageal adenocarcinoma was similar at 80.5% (95% CI, 68.1–88.8%, I2 = 87%). These results remained stable across multiple subgroup analyses including study quality, setting, duration of follow-up and presence of baseline dysplasia. Conclusions: In our meta-analysis, four of five patients diagnosed with adenocarcinoma or high-grade dysplasia at index endoscopy or within 1 year of Barrett's follow-up were considered to be prevalent cases. Continued efforts are needed to identify patients with Barrett's before the development of adenocarcinoma.

Original languageEnglish (US)
Pages (from-to)775-784
Number of pages10
JournalAlimentary Pharmacology and Therapeutics
Volume44
Issue number8
DOIs
StatePublished - Oct 1 2016

Fingerprint

Barrett Esophagus
Meta-Analysis
Adenocarcinoma
Confidence Intervals
MEDLINE
Endoscopy
Cohort Studies

ASJC Scopus subject areas

  • Medicine(all)
  • Pharmacology (medical)

Cite this

Systematic review with meta-analysis : prevalent vs. incident oesophageal adenocarcinoma and high-grade dysplasia in Barrett's oesophagus. / Visrodia, K.; Singh, S.; Krishnamoorthi, R.; Ahlquist, D. A.; Wang, Kenneth Ke Ning; Iyer, Prasad G; Katzka, David A.

In: Alimentary Pharmacology and Therapeutics, Vol. 44, No. 8, 01.10.2016, p. 775-784.

Research output: Contribution to journalReview article

@article{e128cc338af6451491d907ad8be9b4a5,
title = "Systematic review with meta-analysis: prevalent vs. incident oesophageal adenocarcinoma and high-grade dysplasia in Barrett's oesophagus",
abstract = "Background: The proportion of oesophageal adenocarcinoma that is detected concurrently with initial Barrett's oesophagus diagnosis is not well studied. Aim: To compare the proportion of prevalent adenocarcinoma vs. incident adenocarcinoma found during surveillance of Barrett's. Methods: We performed a systematic search of MEDLINE, EMBASE and Web of Science (from their inception to 31 May 2015) for cohort studies in adults with Barrett's (nondysplastic Barrett's ± Barrett's with low-grade dysplasia) with minimum average follow-up of 3 years, and providing numbers of prevalent adenocarcinoma detected (concurrently with Barrett's diagnosis and up to 1 year afterwards) vs. incident adenocarcinoma detected (greater than 1 year after Barrett's diagnosis). Pooled weighted proportions of prevalent and incident adenocarcinoma were calculated, using a random effects model. Results: On meta-analysis of 13 studies reporting on 603 adenocarcinomas in 9657 Barrett's patients, 85.1{\%} of adenocarcinomas were classified as prevalent [95{\%} confidence interval (CI), 78.1–90.2{\%}) and 14.9{\%} as incident (95{\%} CI, 9.8–21.9{\%}), with substantial heterogeneity (I2 = 66{\%}). Among nine studies reporting on 787 high-grade dysplasia and oesophageal adenocarcinomas in 8098 Barrett's patients, the proportion of prevalent high-grade dysplasia-oesophageal adenocarcinoma was similar at 80.5{\%} (95{\%} CI, 68.1–88.8{\%}, I2 = 87{\%}). These results remained stable across multiple subgroup analyses including study quality, setting, duration of follow-up and presence of baseline dysplasia. Conclusions: In our meta-analysis, four of five patients diagnosed with adenocarcinoma or high-grade dysplasia at index endoscopy or within 1 year of Barrett's follow-up were considered to be prevalent cases. Continued efforts are needed to identify patients with Barrett's before the development of adenocarcinoma.",
author = "K. Visrodia and S. Singh and R. Krishnamoorthi and Ahlquist, {D. A.} and Wang, {Kenneth Ke Ning} and Iyer, {Prasad G} and Katzka, {David A}",
year = "2016",
month = "10",
day = "1",
doi = "10.1111/apt.13783",
language = "English (US)",
volume = "44",
pages = "775--784",
journal = "Alimentary Pharmacology and Therapeutics",
issn = "0269-2813",
publisher = "Wiley-Blackwell",
number = "8",

}

TY - JOUR

T1 - Systematic review with meta-analysis

T2 - prevalent vs. incident oesophageal adenocarcinoma and high-grade dysplasia in Barrett's oesophagus

AU - Visrodia, K.

AU - Singh, S.

AU - Krishnamoorthi, R.

AU - Ahlquist, D. A.

AU - Wang, Kenneth Ke Ning

AU - Iyer, Prasad G

AU - Katzka, David A

PY - 2016/10/1

Y1 - 2016/10/1

N2 - Background: The proportion of oesophageal adenocarcinoma that is detected concurrently with initial Barrett's oesophagus diagnosis is not well studied. Aim: To compare the proportion of prevalent adenocarcinoma vs. incident adenocarcinoma found during surveillance of Barrett's. Methods: We performed a systematic search of MEDLINE, EMBASE and Web of Science (from their inception to 31 May 2015) for cohort studies in adults with Barrett's (nondysplastic Barrett's ± Barrett's with low-grade dysplasia) with minimum average follow-up of 3 years, and providing numbers of prevalent adenocarcinoma detected (concurrently with Barrett's diagnosis and up to 1 year afterwards) vs. incident adenocarcinoma detected (greater than 1 year after Barrett's diagnosis). Pooled weighted proportions of prevalent and incident adenocarcinoma were calculated, using a random effects model. Results: On meta-analysis of 13 studies reporting on 603 adenocarcinomas in 9657 Barrett's patients, 85.1% of adenocarcinomas were classified as prevalent [95% confidence interval (CI), 78.1–90.2%) and 14.9% as incident (95% CI, 9.8–21.9%), with substantial heterogeneity (I2 = 66%). Among nine studies reporting on 787 high-grade dysplasia and oesophageal adenocarcinomas in 8098 Barrett's patients, the proportion of prevalent high-grade dysplasia-oesophageal adenocarcinoma was similar at 80.5% (95% CI, 68.1–88.8%, I2 = 87%). These results remained stable across multiple subgroup analyses including study quality, setting, duration of follow-up and presence of baseline dysplasia. Conclusions: In our meta-analysis, four of five patients diagnosed with adenocarcinoma or high-grade dysplasia at index endoscopy or within 1 year of Barrett's follow-up were considered to be prevalent cases. Continued efforts are needed to identify patients with Barrett's before the development of adenocarcinoma.

AB - Background: The proportion of oesophageal adenocarcinoma that is detected concurrently with initial Barrett's oesophagus diagnosis is not well studied. Aim: To compare the proportion of prevalent adenocarcinoma vs. incident adenocarcinoma found during surveillance of Barrett's. Methods: We performed a systematic search of MEDLINE, EMBASE and Web of Science (from their inception to 31 May 2015) for cohort studies in adults with Barrett's (nondysplastic Barrett's ± Barrett's with low-grade dysplasia) with minimum average follow-up of 3 years, and providing numbers of prevalent adenocarcinoma detected (concurrently with Barrett's diagnosis and up to 1 year afterwards) vs. incident adenocarcinoma detected (greater than 1 year after Barrett's diagnosis). Pooled weighted proportions of prevalent and incident adenocarcinoma were calculated, using a random effects model. Results: On meta-analysis of 13 studies reporting on 603 adenocarcinomas in 9657 Barrett's patients, 85.1% of adenocarcinomas were classified as prevalent [95% confidence interval (CI), 78.1–90.2%) and 14.9% as incident (95% CI, 9.8–21.9%), with substantial heterogeneity (I2 = 66%). Among nine studies reporting on 787 high-grade dysplasia and oesophageal adenocarcinomas in 8098 Barrett's patients, the proportion of prevalent high-grade dysplasia-oesophageal adenocarcinoma was similar at 80.5% (95% CI, 68.1–88.8%, I2 = 87%). These results remained stable across multiple subgroup analyses including study quality, setting, duration of follow-up and presence of baseline dysplasia. Conclusions: In our meta-analysis, four of five patients diagnosed with adenocarcinoma or high-grade dysplasia at index endoscopy or within 1 year of Barrett's follow-up were considered to be prevalent cases. Continued efforts are needed to identify patients with Barrett's before the development of adenocarcinoma.

UR - http://www.scopus.com/inward/record.url?scp=84987784788&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84987784788&partnerID=8YFLogxK

U2 - 10.1111/apt.13783

DO - 10.1111/apt.13783

M3 - Review article

C2 - 27562355

AN - SCOPUS:84987784788

VL - 44

SP - 775

EP - 784

JO - Alimentary Pharmacology and Therapeutics

JF - Alimentary Pharmacology and Therapeutics

SN - 0269-2813

IS - 8

ER -