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Diabetes and Barrett’s Esophagus Combo Increase Risk of Cancer

Risk of progression more than doubled….

In a cohort study of 1,623 patients, Thota and colleagues from the Cleveland Clinic found there was an association between Barrett’s esophagus and diabetes. Patients with these disease states had an increased risk for the esophageal to develop into cancer. The risk of progression was more than doubled in these patients. In the same study, patients without hypertension had twice the risk of progression.

There were a total of 274 patients who had diabetes or were diagnosed with diabetes during the study period which was conducted between December 2000 and March 2013. The researchers observed no significant differences between sex, race, and the length of the Barrett’s esophagus segment or size of hiatal hernia. During the 16 months of follow-up, adenocarcinoma was found in 15.8% of patients without diabetes and 25.9% in patients with diabetes. It was observed that the progression to high-grade dysplasia was almost doubled in patients with diabetes (17.9% vs. 9.7%).

Hypertension was also observed to see if there were any contributions to the risk of progression. It was found that 41.8% of the patients had hypertension and 32.8% of these patients had diabetes. There was a significant difference in length of the Barrett’s esophagus segment in those without hypertension. Adenocarcinoma was found in 16.3% of patients with hypertension and 17.2% in patients without hypertension.

Practice Pearls:
  • Risk of progression doubles in patients with Barrett’s esophagus and diabetes.
  • Hypertension common in patients with Barrett’s esophagus.
  • Patients with diabetes more likely to have hypertension.

American College of Gastroenterology Sept. 2013