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Barrett’s Metaplasia and Colonic Neoplasms: A Significant Association in a 203,534-Patient Study

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Abstract

Background and Aim

The presence of an association between Barrett’s metaplasia and colonic neoplasia has remained controversial. The aim of the study was to test the presence of this association, using a large national database.

Methods

From a computerized database of surgical pathology reports, we selected 203,000 subjects who underwent colonoscopy and esophago-gastro-duodenoscopy with biopsy results available from both procedures. In a case–control study we compared the occurrence of Barrett’s metaplasia in patients with and without various types of colonic neoplasms.

Results

Barrett’s metaplasia occurred more frequently among patients with hyperplastic polyps (OR = 2.14, 95 % CI 2.02–2.27), adenomatous polyps (2.52, 2.41–2.64), advanced adenomas (2.10, 1.90–2.32), villous adenomas or adenomas with high-grade (HG) dysplasia (2.45, 2.28–2.64), and colonic adenocarcinomas (1.75, 1.39–2.22). The association between Barrett’s metaplasia and colonic neoplasm applied similarly to polyps of different size, number and location within the large bowel. These types of association could also be confirmed when analyzed separately for Barrett’s metaplasia characterized by low-grade or HG dysplasia, as well as esophageal adenocarcinoma.

Conclusions

The data support the existence of a true association between Barrett’s metaplasia and various types of colonic neoplasm. The association may be more interesting for its potential insights into the pathogenesis of the two disorders than its actual clinical implications.

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Abbreviations

CI:

Confidence interval

EGD:

Esophago-gastro-duodenoscopy

HG:

High-grade

OR:

Odds ratio

P :

Probability

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Conflict of interest

Robert M. Genta is employed by Miraca Life Sciences, Irving, TX, USA. Amnon Sonnenberg is supported by a grant from Takeda Pharmaceuticals. No funding was obtained for this study.

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Authors and Affiliations

  1. Gastroenterology, Portland VA Medical Center P3-GI, 3710 SW US Veterans Hospital Road, Portland, OR, 97239, USA

    Amnon Sonnenberg

  2. Oregon Health and Science University, Portland, OR, USA

    Amnon Sonnenberg

  3. Miraca Life Sciences, Irving, TX, USA

    Robert M. Genta

  4. University of Texas Southwestern Medical Center, Dallas, TX, USA

    Robert M. Genta

  5. Dallas VA Medical Center, Dallas, TX, USA

    Robert M. Genta

Authors
  1. Amnon Sonnenberg
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  2. Robert M. Genta
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Correspondence to Amnon Sonnenberg.

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Sonnenberg, A., Genta, R.M. Barrett’s Metaplasia and Colonic Neoplasms: A Significant Association in a 203,534-Patient Study. Dig Dis Sci 58, 2046–2051 (2013). https://doi.org/10.1007/s10620-013-2565-5

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  • DOI: https://doi.org/10.1007/s10620-013-2565-5

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