Interactions among smoking, obesity, and symptoms of acid reflux in Barrett's esophagus

Smith, Kylie J., O'Brien, Suzanne M., Smithers, B. Mark, Gotley, David C., Webb, Penelope M., Green, Adèle C. and Whiteman, David C. (2005) Interactions among smoking, obesity, and symptoms of acid reflux in Barrett's esophagus. Cancer Epidemiology Biomarkers & Prevention, 14 11: 2481-2486. doi:10.1158/1055-9965.EPI-05-0370

Author Smith, Kylie J.
O'Brien, Suzanne M.
Smithers, B. Mark
Gotley, David C.
Webb, Penelope M.
Green, Adèle C.
Whiteman, David C.
Title Interactions among smoking, obesity, and symptoms of acid reflux in Barrett's esophagus
Journal name Cancer Epidemiology Biomarkers & Prevention   Check publisher's open access policy
ISSN 1055-9965
Publication date 2005-11-01
Sub-type Article (original research)
DOI 10.1158/1055-9965.EPI-05-0370
Open Access Status DOI
Volume 14
Issue 11
Start page 2481
End page 2486
Total pages 6
Editor J. D. Potter
Place of publication Birmingham, AL
Publisher American Association for Cancer Research
Language eng
Subject C1
321202 Epidemiology
730108 Cancer and related disorders
Abstract Background: Barrett's esophagus, a metaplastic precursor to esophageal adenocarcinoma, is becoming increasingly prevalent in many populations. Clinical studies suggest acid reflux causes Barrett's esophagus; however, no population-based estimates of risk have been reported, and the role of other health factors in modifying risk is unclear. Methods: We conducted a population-based case-control study in Brisbane, Australia. Cases were 167 patients with histologically confirmed Barrett's esophagus diagnosed between February and December 2003. Age-matched and sex-matched controls (n = 261) were randomly selected from a population register. Data on exposure to self-reported symptoms of acid reflux, smoking, obesity, and other factors were collected through self-completed questionnaires followed by telephone interview. Risks of Barrett's esophagus and Barrett's esophagus with dysplasia associated with these exposures were estimated by the odds ratio (OR) and 95% confidence interval (95% Cl), both crude and adjusted for other factors. Results: Self-reported weekly episodes of acid reflux were associated with greatly increased risks of Barrett's esophagus (adjusted OR, 29.7; 95% CI, 12.2-72.6) and Barrett's esophagus with dysplasia (OR, 59.7; 95% CI, 18.5-193). Smoking was also associated with risk of Barrett's esophagus. We found evidence of interactions between symptoms of acid reflux and smoking and obesity. Obese people with self-reported symptoms of acid reflux had markedly higher risks of Barrett's esophagus (OR, 34.4; 95% CI, 6.3-188) than people with reflux alone (OR, 9.3; 95% CI, 1.4-62.2) or obesity alone (OR, 0.7,95% CI, 0.2-2.4). Similarly, those reporting both acid reflux symptoms and smoking were at substantially higher risks of Barrett's esophagus (OR, 51.4; 95% CI, 14.1-188) than those reporting acid reflux or smoking alone. Conclusions: Although history of symptoms of acid reflux is the principle factor associated with Barrett's esophagus, risks are substantially increased by obesity and smoking.
Keyword Oncology
Public, Environmental & Occupational Health
Nonsteroidal Antiinflammatory Drugs
Body-mass Index
Gastric Cardia
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
2006 Higher Education Research Data Collection
School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 87 times in Thomson Reuters Web of Science Article | Citations
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Created: Wed, 15 Aug 2007, 16:47:06 EST