Epidemiological risk factors in a comparison of a Barrett Esophagus Registry (BarretNET) and a case control population in Germany.

Endoscopic screening for Barrett's esophagus (BE) as the major precursor lesion for oesophageal adenocarcinoma (OAC) is mostly offered to patients with symptoms of gastro-oesophageal reflux disease (GERD). However, other epidemiological risk factors might affect the development of BE and OAC. Therefore, efforts to improve the efficiency of screening to find the BE population "at risk" compared to the normal population are needed. In a cross-sectional analysis, we compared 587 BE patients from the multicenter German BarrettNET registry to 1976 healthy subjects from the population-based German KORA cohort, with and without GERD symptoms. Data on demographic and lifestyle factors, including age, gender, smoking, alcohol consumption, body mass index, physical activity and symptoms were collected in a standardized epidemiological survey. Increased age, male gender, smoking, heavy alcohol consumption, low physical activity, low health status and GERD symptoms were significantly associated with BE. Surprisingly, among patients stratified for GERD symptoms, these associations did not change. Demographic, lifestyle and clinical factors as well as GERD symptoms are associated with BE development in Germany, suggesting that a combination of risk factors could be useful in developing individualized screening efforts for BE and GERD patients in Germany.