Epidemiology and Incidence of Barrett's Esophagus

Summary

Principal Investigator: DOUGLAS ALLEN CORLEY
Abstract: DESCRIPTION (provided by applicant): The continuing overall objective of this application is to improve the understanding of early events leading to Barrett's esophagus (a risk factor for esophageal adenocarcinoma), and to identify potential targets for early intervention. Barrett's esophagus is a metaplastic change in the lining of the esophagus that is commonly considered to be a strong risk factor for and precursor to esophageal adenocarcinoma. The incidence of esophageal adenocarcinoma has been rising more rapidly than that of any malignancy in the United States for the last three decades;however, explanations for the marked incidence increase, and its marked incidence variation by ethnicity and gender (three times more common among Caucasian men than among women or African Americans) remain elusive. Obesity is a major risk factor for many cancers (including esophageal adenocarcinoma), although the mechanisms are unknown. The pathway between obesity and cancer may be through intermediary, adipose-associated hormones, such as leptin, adiponectin, ghrelin and insulin-like growth factors. These hormone systems have demonstrated experimental effects on inflammation, healing, and the risk of neoplasia and they may differ by gender and ethnicity. They therefore represent a potential mechanistic link in the individual pathway to Barrett's esophagus and may help explain why among many persons with reflux disease, only some develop Barrett's esophagus and esophageal adenocarcinoma. Thus, we propose to evaluate the associations between adipose-associated hormones, obesity, body fat distribution, and Barrett's esophagus. The specific aims of this study will be to evaluate the associations between leptin, adiponectin, and ghrelin and the risk of Barrett's esophagus, compared with GERD controls and population controls. The project will be a continuation of a recently established, high-quality, community-based case- control study of patients with a new Barrett's esophagus diagnosis, patients with gastroesophageal reflux disease, and population controls. Subjects completed detailed interviews, physical/anthropometric examinations, food frequency questionnaires, and serum samples. Serum samples are available for 99% of subjects. The proposed research will extend a highly novel translational research effort, is supported by a substantial body of literature for similar disorders, will leverage resources from an existing productive multidisciplinary research team, and may permit elucidation of an entirely new direction in determining why patients get Barrett's esophagus and esophageal adenocarcinoma. PUBLIC HEALTH RELEVANCE: Barrett's esophagus (BE) is a precancerous condition of the esophagus that is very common;it is a strong risk factor for a kind of esophageal cancer that has become much more frequent seen in recent years. The objective of this application is to improve the understanding of what causes Barrett's esophagus and identify potential targets for intervention. The proposed study explores how hormones associated with body fat may change the way the body heals after an injury, and increase the risk of cells developing precancerous changes.
Funding Period: ----------------2002 - ---------------2011-
more information: NIH RePORT

Top Publications

  1. ncbi Body mass index and adenocarcinomas of the esophagus or gastric cardia: a systematic review and meta-analysis
    Ai Kubo
    Kaiser Permanente Division of Research, 2000 Broadway, Oakland, CA 94612, USA
    Cancer Epidemiol Biomarkers Prev 15:872-8. 2006
  2. pmc A genome-wide association study identifies new susceptibility loci for esophageal adenocarcinoma and Barrett's esophagus
    David M Levine
    Department of Biostatistics, University of Washington, School of Public Health, Seattle, Washington, USA
    Nat Genet 45:1487-93. 2013
  3. pmc Impact of endoscopic surveillance on mortality from Barrett's esophagus-associated esophageal adenocarcinomas
    Douglas A Corley
    Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
    Gastroenterology 145:312-9.e1. 2013
  4. pmc Helicobacter pylori and gastroesophageal reflux disease: a case-control study
    Douglas A Corley
    Division of Research, Kaiser Permanente, Oakland, California 94612 2304, USA
    Helicobacter 13:352-60. 2008
  5. pmc Germline genetic contributions to risk for esophageal adenocarcinoma, Barrett's esophagus, and gastroesophageal reflux
    Weronica E Ek
    Affiliations of authors Statistical Genetics WEE, SM and Cancer Control Group DCW, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia WEE, SM Department of Biostatistics, University of Washington, Seattle, WA DML Department of Biosciences and Nutrition MD, FB, MZ Department of Medical Epidemiology and Biostatistics NLP, PKEM, Unit of Upper Gastrointestinal Research, Department of Molecular Medicine and Surgery HN, and Department of Medical Epidemiology and Biostatistics WY, Karolinska Institutet, Stockholm, Sweden Gastrocentrum Medicin, Karolinska University Hospital, Stockholm, Sweden FB, PTS Division of Public Health Sciences LEO, TLV and Division of Human Biology BJR, Fred Hutchinson Cancer Research Center, Seattle, WA Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden HT Division of Gastroenterology and Hepatology YR, Department of Otolaryngology YR, and GI Outcomes Unit YR, Mayo Clinic, Rochester, MN Department of Epidemiology, MD Anderson Cancer Center, Houston, TX W HC Centre for Public Health, Department of Pediatrics
    J Natl Cancer Inst 105:1711-8. 2013
  6. pmc Iron intake and body iron stores as risk factors for Barrett's esophagus: a community-based study
    Douglas A Corley
    Division of Research, Kaiser Permanente, Oakland, California 94612, USA
    Am J Gastroenterol 103:2997-3004. 2008
  7. pmc Dietary antioxidants, fruits, and vegetables and the risk of Barrett's esophagus
    Ai Kubo
    Division of Research, Kaiser Permanente, Oakland, California 94612, USA
    Am J Gastroenterol 103:1614-23; quiz 1624. 2008
  8. pmc Hemochromatosis gene status as a risk factor for Barrett's esophagus
    Douglas A Corley
    Division of Research, Kaiser Permanente, 2000 Broadway, Oakland, CA, 94612, USA
    Dig Dis Sci 53:3095-102. 2008
  9. pmc Abdominal obesity and the risk of esophageal and gastric cardia carcinomas
    Douglas A Corley
    Kaiser Permanente Division of Research, 2000 Broadway, Oakland, CA 94612, USA
    Cancer Epidemiol Biomarkers Prev 17:352-8. 2008
  10. ncbi Abdominal obesity and body mass index as risk factors for Barrett's esophagus
    Douglas A Corley
    Division of Research, Kaiser Permanente, Oakland, California 94612, USA
    Gastroenterology 133:34-41; quiz 311. 2007

Scientific Experts

  • Michael B Cook
  • J H Lubin
  • N D Freedman
  • Ai Kubo
  • L Hol
  • DOUGLAS ALLEN CORLEY
  • David M Levine
  • Weronica E Ek
  • David C Whiteman
  • Liam J Murray
  • Wong Ho Chow
  • Nicholas J Shaheen
  • Nigel C Bird
  • Brian J Reid
  • Geoffrey Liu
  • Weimin Ye
  • Thomas L Vaughan
  • Alan G Casson
  • Stuart Macgregor
  • Yvonne Romero
  • Laura J Hardie
  • Anna H Wu
  • Leslie Bernstein
  • Marilie D Gammon
  • Harvey A Risch
  • Jennifer Lee
  • Deirdre P Cronin-Fenton
  • Carlos Caldas
  • Marco Zucchelli
  • Isabel Caldas
  • Mauro D'Amato
  • Olof Nyren
  • Cassandra Sather
  • Francesca Bresso
  • Pierre Lao-Sirieix
  • Peter T Schmidt
  • Lynn Onstad
  • Nicholas K Hayward
  • Tim D Spector
  • Patrik K E Magnusson
  • Helena Nordenstedt
  • Nancy L Pedersen
  • Rebecca C Fitzgerald
  • Hans Tornblom
  • Stephen J Chanock
  • Rui Zhang
  • Lynn E Onstad
  • Patricia Harrington
  • Xinxue Liu
  • Irene Debiram-Beecham
  • Pirro Hysi
  • Paul D Pharoah
  • James L Graham
  • Elizabeth Martin
  • Kimber L Stanhope
  • Bethany P Cummings
  • James W Sharp
  • Helen E Raybould
  • Peter J Havel
  • Chris Cardwell
  • Jesper Lagergren
  • Penelope M Webb
  • Linda Sharp
  • Susan J Jordan

Detail Information

Publications26

  1. ncbi Body mass index and adenocarcinomas of the esophagus or gastric cardia: a systematic review and meta-analysis
    Ai Kubo
    Kaiser Permanente Division of Research, 2000 Broadway, Oakland, CA 94612, USA
    Cancer Epidemiol Biomarkers Prev 15:872-8. 2006
    ..We did a systematic review and statistical synthesis of studies that evaluated the association between body mass index (BMI) and the risk of esophageal adenocarcinoma or the adjacent gastric cardia adenocarcinoma...
  2. pmc A genome-wide association study identifies new susceptibility loci for esophageal adenocarcinoma and Barrett's esophagus
    David M Levine
    Department of Biostatistics, University of Washington, School of Public Health, Seattle, Washington, USA
    Nat Genet 45:1487-93. 2013
    ..We also refine a previously reported association with Barrett's esophagus near the putative tumor suppressor gene FOXF1 at 16q24 and extend our findings to now include esophageal adenocarcinoma. ..
  3. pmc Impact of endoscopic surveillance on mortality from Barrett's esophagus-associated esophageal adenocarcinomas
    Douglas A Corley
    Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
    Gastroenterology 145:312-9.e1. 2013
    ..Although patients with Barrett's esophagus commonly undergo endoscopic surveillance, its effectiveness in reducing mortality from esophageal/gastroesophageal junction adenocarcinomas has not been evaluated rigorously...
  4. pmc Helicobacter pylori and gastroesophageal reflux disease: a case-control study
    Douglas A Corley
    Division of Research, Kaiser Permanente, Oakland, California 94612 2304, USA
    Helicobacter 13:352-60. 2008
    ..Gastric colonization with Helicobacter pylori is a proposed protective factor against gastroesophageal reflux disease (GERD), but little population-based data exist and other data conflict...
  5. pmc Germline genetic contributions to risk for esophageal adenocarcinoma, Barrett's esophagus, and gastroesophageal reflux
    Weronica E Ek
    Affiliations of authors Statistical Genetics WEE, SM and Cancer Control Group DCW, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia WEE, SM Department of Biostatistics, University of Washington, Seattle, WA DML Department of Biosciences and Nutrition MD, FB, MZ Department of Medical Epidemiology and Biostatistics NLP, PKEM, Unit of Upper Gastrointestinal Research, Department of Molecular Medicine and Surgery HN, and Department of Medical Epidemiology and Biostatistics WY, Karolinska Institutet, Stockholm, Sweden Gastrocentrum Medicin, Karolinska University Hospital, Stockholm, Sweden FB, PTS Division of Public Health Sciences LEO, TLV and Division of Human Biology BJR, Fred Hutchinson Cancer Research Center, Seattle, WA Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden HT Division of Gastroenterology and Hepatology YR, Department of Otolaryngology YR, and GI Outcomes Unit YR, Mayo Clinic, Rochester, MN Department of Epidemiology, MD Anderson Cancer Center, Houston, TX W HC Centre for Public Health, Department of Pediatrics
    J Natl Cancer Inst 105:1711-8. 2013
    ..Barrett's esophagus (BE) is the main precursor to EA, and every year 0.12% to 0.5% of BE patients progress to EA. BE typically arises on a background of chronic gastroesophageal reflux (GERD), one of the risk factors for EA...
  6. pmc Iron intake and body iron stores as risk factors for Barrett's esophagus: a community-based study
    Douglas A Corley
    Division of Research, Kaiser Permanente, Oakland, California 94612, USA
    Am J Gastroenterol 103:2997-3004. 2008
    ..We evaluated whether iron intake and iron stores were associated with Barrett's esophagus, a metaplastic change that is a strong risk factor for esophageal adenocarcinoma...
  7. pmc Dietary antioxidants, fruits, and vegetables and the risk of Barrett's esophagus
    Ai Kubo
    Division of Research, Kaiser Permanente, Oakland, California 94612, USA
    Am J Gastroenterol 103:1614-23; quiz 1624. 2008
    ..The present study evaluated the associations among antioxidants, fruit and vegetable intake, and the risk of Barrett's esophagus (BE), a potential precursor to esophageal adenocarcinoma...
  8. pmc Hemochromatosis gene status as a risk factor for Barrett's esophagus
    Douglas A Corley
    Division of Research, Kaiser Permanente, 2000 Broadway, Oakland, CA, 94612, USA
    Dig Dis Sci 53:3095-102. 2008
    ..As expected, gene defects were associated with increased iron stores. We can conclude from our findings that Barrett's esophagus was not associated with hemochromatosis gene defects, although we cannot exclude small effects...
  9. pmc Abdominal obesity and the risk of esophageal and gastric cardia carcinomas
    Douglas A Corley
    Kaiser Permanente Division of Research, 2000 Broadway, Oakland, CA 94612, USA
    Cancer Epidemiol Biomarkers Prev 17:352-8. 2008
    ..Abdominal obesity patterns may explain this discordance, but no studies exist to date...
  10. ncbi Abdominal obesity and body mass index as risk factors for Barrett's esophagus
    Douglas A Corley
    Division of Research, Kaiser Permanente, Oakland, California 94612, USA
    Gastroenterology 133:34-41; quiz 311. 2007
    ..Barrett's esophagus is a strong risk factor for esophageal adenocarcinoma, but little is known about its associations with body mass index (BMI) or abdominal obesity...
  11. pmc Helicobacter pylori infection and the risk of Barrett's oesophagus: a community-based study
    D A Corley
    Division of Research, Kaiser Permanente, 2000 Broadway, Oakland, CA 94612, USA
    Gut 57:727-33. 2008
    ..Its associations with Barrett's oesophagus, a metaplastic change that is a probable early event in the carcinogenesis of oesophageal adenocarcinoma, were evaluated..
  12. pmc Abdominal obesity, ethnicity and gastro-oesophageal reflux symptoms
    Douglas A Corley
    Kaiser Permanente Division of Research, 2000 Broadway, Oakland, CA 94612, USA
    Gut 56:756-62. 2007
    ..To evaluate the associations between abdominal obesity and gastro-oesophageal reflux disease (GORD), and their interactions with ethnicity and gender...
  13. ncbi Dietary patterns and the risk of Barrett's esophagus
    Ai Kubo
    Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA
    Am J Epidemiol 167:839-46. 2008
    ..Results suggest strong associations between a diet rich in fruits and vegetables and the risk of Barrett's esophagus...
  14. ncbi Body mass index and gastroesophageal reflux disease: a systematic review and meta-analysis
    Douglas A Corley
    Kaiser Permanente, Northern California, Division of Research, Oakland, California 94612, USA
    Am J Gastroenterol 101:2619-28. 2006
    ..Obesity is a potentially modifiable risk factor, but existing studies have conflicting results, possibly due to differences in study design, definitions, or populations...
  15. pmc The importance of exposure rate on odds ratios by cigarette smoking and alcohol consumption for esophageal adenocarcinoma and squamous cell carcinoma in the Barrett's Esophagus and Esophageal Adenocarcinoma Consortium
    Jay H Lubin
    Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH DHHS, Bethesda, MD 20892, USA
    Cancer Epidemiol 36:306-16. 2012
    ..e., the impact on the OR for a fixed total exposure of high exposure rate for short duration compared with low exposure rate for long duration...
  16. pmc Cigarette smoking increases risk of Barrett's esophagus: an analysis of the Barrett's and Esophageal Adenocarcinoma Consortium
    Michael B Cook
    Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland 20852 7234, USA
    Gastroenterology 142:744-53. 2012
    ..We investigated whether tobacco smoking and other factors increase risk for Barrett's esophagus...
  17. pmc Glucose sensing by gut endocrine cells and activation of the vagal afferent pathway is impaired in a rodent model of type 2 diabetes mellitus
    Jennifer Lee
    Department of Anatomy, Physiology and Cell Biology, School of Veterinary Medicine, University of California, Davis, California 95616, USA
    Am J Physiol Regul Integr Comp Physiol 302:R657-66. 2012
    ..01, P < 0.001, respectively) in RD and 3MD. These data suggest that glucose sensing in enteroendocrine and enterochromaffin cells and activation of neural pathways is markedly impaired in UCD-T2DM rats...
  18. pmc Alcohol intake and risk of oesophageal adenocarcinoma: a pooled analysis from the BEACON Consortium
    Neal D Freedman
    Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Rockville, MD 20852, USA
    Gut 60:1029-37. 2011
    ..Therefore, the association of alcohol intake with OSCC, OA, and OGJA was determined in nine case-control studies and two cohort studies of the Barrett's Esophagus and Esophageal Adenocarcinoma Consortium (BEACON)...
  19. pmc Cigarette smoking and adenocarcinomas of the esophagus and esophagogastric junction: a pooled analysis from the international BEACON consortium
    Michael B Cook
    Hormonal and Reproductive Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health DHHS, 6120 Executive Blvd, Bethesda, MD 20852 7234, USA
    J Natl Cancer Inst 102:1344-53. 2010
    ....
  20. ncbi Reproductive and sex hormonal factors and oesophageal and gastric junction adenocarcinoma: a pooled analysis
    Deirdre P Cronin-Fenton
    Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes 43 45, 8200 Aarhus N, Denmark
    Eur J Cancer 46:2067-76. 2010
    ..We therefore pooled data on women from four population-based case-control studies to examine the association of female reproductive and sex hormonal factors with oesophageal and gastric junction adenocarcinoma...
  21. pmc Proton pump inhibitors and histamine-2 receptor antagonists are associated with hip fractures among at-risk patients
    Douglas A Corley
    Kaiser Permanente Division of Research, Oakland, California 94612, USA
    Gastroenterology 139:93-101. 2010
    ..Drugs that inhibit gastric acid might increase the risk of hip fracture. However, little long-term exposure data exist and no large studies have been conducted in the United States...
  22. pmc Alcohol types and sociodemographic characteristics as risk factors for Barrett's esophagus
    Ai Kubo
    Division of Research, Kaiser Permanente, Oakland, California, USA
    Gastroenterology 136:806-15. 2009
    ..We evaluated the association between alcohol use, alcohol type, sociodemographic profiles, other lifestyle factors, and the risk of Barrett's esophagus...
  23. pmc Race, ethnicity, sex and temporal differences in Barrett's oesophagus diagnosis: a large community-based study, 1994-2006
    D A Corley
    Division of Research, Kaiser Permanente, Oakland, CA 94612, USA
    Gut 58:182-8. 2009
    ..To evaluate the demographics and incidence of Barrett's oesophagus diagnosis using community-based data...
  24. pmc Cigarette smoking and the risk of Barrett's esophagus
    Ai Kubo
    Division of Research, Kaiser Permanente, 2000 Broadway, Oakland, CA 94612, USA
    Cancer Causes Control 20:303-11. 2009
    ..We examined the association between smoking and the risk of Barrett's esophagus (BE), a metaplastic precursor to esophageal adenocarcinoma...
  25. pmc Diagnosing Barrett's esophagus: reliability of clinical and pathologic diagnoses
    Douglas A Corley
    Division of Research, Kaiser Permanente, Northern California, Oakland, California 94612, USA
    Gastrointest Endosc 69:1004-10. 2009
    ..The accuracy of a Barrett's esophagus diagnosis is not well studied...