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A random Abstract
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The Incidence of Esophageal Adenocarcinoma in a National Veterans Cohort With Barrett's Esophagus.
[esophageal adenocarcinoma]
OBJECTIVES
:
The
increasing
incidence
of
esophageal
adenocarcinoma
(
EA
)
in
the
United
States
may
have
leveled
off
in
recent
years
.
The
risk
of
EA
among
patients
with
Barrett
's
esophagus
(
BE
)
seems
to
be
decreasing
in
several
European
cohorts
,
but
these
estimates
are
unknown
in
the
United
States
.
We
aimed
to
determine
the
risk
of
developing
EA
in
a
national
cohort
of
BE
patients
in
the
US
Veterans
Health
Administration
and
to
account
for
the
use
of
endoscopic
ablation
and
esophagectomy
.
METHODS
:
This
was
a
retrospective
cohort
study
from
a
total
of
121
facilities
in
the
Veterans
Health
Administration
.
Veteran
patients
with
BE
diagnosed
between
1
October
2003
and
30
September
2009
were
included
and
followed
until
esophageal
cancer
diagnosis
,
death
or
30
September
2011
.
All
EA
diagnoses
were
verified
in
detailed
structured
reviews
of
medical
records
.
RESULTS
:
We
identified
29
,
536
patients
with
BE
who
met
our
eligibility
criteria
.
Most
were
men
(
96
.
9
%
)
and
White
(
83
.
2
%
)
,
with
a
mean
age
of
61
.
8
years
.
During
144
,
949
person-
years
of
follow-up
,
466
patients
developed
EA
,
yielding
an
incidence
rate
of
3
.
21
per
1
,
000
person-
years
(
95
%
confidence
interval
(
CI
)
2
.
94
-
3
.
52
)
.
Excluding
those
who
developed
EA
within
1
year
of
their
index
BE
date
lowered
the
incidence
rate
to
1
.
75
per
1
,
000
person-
years
.
However
,
including
additional
patients
who
underwent
endoscopic
ablation
or
esophagectomy
for
HGD
or
EA
increased
the
incidence
rate
to
4
.
79
(
95
%
CI
4
.
44
-
5
.
16
)
.
CONCLUSIONS
:
The
incidence
of
EA
in
a
US
national
cohort
of
mostly
male
veterans
may
be
lower
than
previous
estimates
.
Almost
half
of
the
EA
cases
were
diagnosed
within
1
year
of
their
BE
index
date
.
Am
J
Gastroenterol
advance
online
publication
,
21
October
2014
;
doi
:
10
.
1038
/
ajg
.
2014
.
324
.
Diseases
Validation
Diseases presenting
"cancer"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
alpha-thalassemia
benign recurrent intrahepatic cholestasis
cadasil
canavan disease
carcinoma of the gallbladder
cholangiocarcinoma
coats disease
congenital adrenal hyperplasia
congenital diaphragmatic hernia
cowden syndrome
cushing syndrome
cutaneous mastocytosis
dedifferentiated liposarcoma
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erdheim-chester disease
erythropoietic protoporphyria
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
familial hypocalciuric hypercalcemia
familial mediterranean fever
gm1 gangliosidosis
heparin-induced thrombocytopenia
hereditary cerebral hemorrhage with amyloidosis
hirschsprung disease
hodgkin lymphoma, classical
inclusion body myositis
junctional epidermolysis bullosa
kabuki syndrome
kallmann syndrome
kindler syndrome
lamellar ichthyosis
liposarcoma
locked-in syndrome
lymphangioleiomyomatosis
monosomy 21
neuralgic amyotrophy
oculocutaneous albinism
oligodontia
oral submucous fibrosis
papillon-lefèvre syndrome
pendred syndrome
pleomorphic liposarcoma
primary effusion lymphoma
proteus syndrome
pyomyositis
pyruvate dehydrogenase deficiency
severe combined immunodeficiency
sneddon syndrome
systemic capillary leak syndrome
triple a syndrome
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
werner syndrome
wiskott-aldrich syndrome
wolf-hirschhorn syndrome
x-linked adrenoleukodystrophy
This symptom has already been validated
