A systematic review of the association between Barrett's esophagus and colon neoplasms.

OBJECTIVE: Patients with Barrett's esophagus may be at increased risk of colon neoplasms, including cancer. However, different studies of this have yielded conflicting results. The objective of this analysis was to review all existing published data in an attempt to determine whether there is such an association and, if so, to estimate the level of risk.

METHODS: We have reviewed all of the published studies examining the prevalence of colon neoplasms in patients with Barrett's esophagus. We have compared these with a cohort of patients drawn from the general population and participating in colorectal cancer screening programs.

RESULTS: The prevalence of colon cancer in patients with Barrett's esophagus was 7.6% compared with 1.6% in the control group. The pooled odds ratio for colon cancer in Barrett's esophagus was 5.19 (p < 0.0001). In a small subgroup analysis, the odds ratio for colon cancer in patients identified as having Barrett's esophagus with specialized columnar epithelium was 8.71 (p < 0.0001).

CONCLUSIONS: We conclude that patients with Barrett's esophagus have an increased risk of colon cancer. This may be particularly true in those patients with specialized columnar epithelium.