- In Barrett's esophagus, risk for progression to high-grade dysplasia (HGD) or esophageal adenocarcinoma (EAC) with indefinite dysplasia (BE-IND) is similar to that previously reported for low-grade dysplasia (BE-LGD).
Why this matters
- Findings support guidelines from the American College of Gastroenterology for endoscopic surveillance of BE-IND every 12 months, which were based on expert opinion.
- Meta-analysis of 8 studies of patients with BE-IND (n=1441).
- Funding: None disclosed.
- HGD and/or EAC pooled incidence, 1.5 (95% CI, 1.0-2.0) per 100 person-years during 5306.2 person-years of follow-up (moderate heterogeneity, I2=56.5%).
- HGD and/or EAC risk estimate for BE-LGD, 0.5%.
- EAC pooled incidence, 0.6 (95% CI, 0.1-1.1) per 100 person-years (considerable heterogeneity, I2=89.0%).
- EAC risk estimate for BE-LGD, 1.7%.
- EAC frequency was higher in Europe than North America (0.9% vs 0.1%; P=.01).
- Pooled incidence of LGD in BE-IND was 11.4 per 100 person-years (95% CI, 0.06-0.2; I2=83.6%).
- Meta-analysis assumed constant incidence rate.
- Possible misclassification bias in the included studies.