Barrett's patients who smoke are twice as likely to develop esophageal cancer

Barrett's esophagus (BE) patients who smoke tobacco are at a two-fold increased risk of developing esophageal cancer, according to a new study in Gastroenterology, the official journal of the American Gastroenterological Association. BE patients who smoke also double their risk for developing advanced precancerous cells.

"We found that tobacco smoking emerged as the strongest lifestyle risk factor for cancer progression. Contrary to popular belief, alcohol consumption didn't increase cancer risk in this group of patients with Barrett's esophagus," said Helen G. Coleman, PhD, of Queen's University Belfast in Northern Ireland and the lead author of this study.

While analyzing data (ranging from 1993 to 2005) from one of the largest population-based cohorts of more than 3,000 BE patients worldwide, doctors found that by Dec. 31, 2008, 117 of the patients developed dysplasia or cancers of the esophagus or stomach. For the first time in such a large study, researchers were able to get information about smoking at the time a person was first diagnosed with BE to see how this influenced cancer risk years later. This is important for reducing bias known to be associated with asking patients about their smoking habits in the past.

Current tobacco smoking, regardless of the number of daily cigarettes, was significantly associated with an increased risk of esophageal cancer. This suggests that reducing the number of cigarettes smoked per day may not reduce the risk of cancer in BE patients.

The incidence of esophageal cancer is on the rise in developed countries. It originates from the premalignant condition BE, presumably progressing through low- and high-grade dysplasia (precancerous cells). However, progression along this pathway is uncommon, and the vast majority of BE patients never develop esophageal cancer or high-grade dysplasia. Factors distinguishing the small minority of patients who do progress remain largely elusive. This underscores the importance of identifying modifiable lifestyle factors that may contribute to cancer progression.

Barrett's Esophagus: Symptoms, Causes, and Treatments Barrett's esophagus is a serious complication of GERD, which stands for gastroesophageal reflux disease. In Barrett's esophagus, normal tissue lining the esophagus - the tube that carries food from the mouth to the stomach - changes to tissue that resembles the lining of the intestine. About 10%-15% of people with chronic symptoms of GERD develop Barrett's esophagus.

Barrett's esophagus does not have any specific symptoms. Patients with Barrett's esophagus may have symptoms related to GERD. It does, though, increase the risk of developing esophageal adenocarcinoma, which is a serious, potentially fatal cancer of the esophagus.

Although the risk of this cancer is higher in people with Barrett's esophagus, the disease is still rare. Less than 1% of the people with Barrett's esophagus develop this particular cancer. Nevertheless, if you've been diagnosed with Barrett's esophagus, it's important to have routine examinations of your esophagus. With routine examination, your doctor can discover precancerous and cancer cells early, before they spread and when the disease is easier to treat.