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Familiality in Barrett's Esophagus, Adenocarcinoma of the Esophagus, and Adenocarcinoma of the Gastroesophageal Junction

¹ Division of Gastroenterology and ² Department of Pathology, University Hospitals of Cleveland and Ireland Cancer Center, ³ Department of Genetics, CASE Comprehensive Cancer Center, Case Western Reserve University School of Medicine; ⁴ Department of Epidemiology and Biostatistics, Case Western Reserve University School of Medicine; ⁵ Division of Gastroenterology, Wade Park VA Medical Center, Case Western Reserve University School of Medicine; ⁶ Center for Swallowing and Esophageal Disorders, Department of Gastroenterology and Hepatology, Cleveland Clinic Foundation; ⁷ Genomic Medicine Institute and Taussig Cancer Center, Cleveland Clinic Foundation, Cleveland, Ohio; ⁸ Vanderbilt University, Nashville, Tennessee; and ⁹ Division of Human Genetics, The Ohio State University, Columbus, Ohio

Requests for reprints: Amitabh Chak, University Hospitals of Cleveland, Case School of Medicine, 11100 Euclid Avenue, Cleveland, OH 44106. Phone: 216-844-5385; Fax: 216-983-0347. E-mail: Amitabh.chak{at}case.edu

Background and Aim: The familial aggregation of Barrett's esophagus, adenocarcinoma of the esophagus, and adenocarcinoma of the gastroesophageal junction, jointly termed familial Barrett's esophagus, may represent a complex genetic trait. The aim of this study was to determine the proportion of patients with these diseases who have familial Barrett's esophagus.

Methods: Information on gastroesophageal reflux symptoms, known risk factors for Barrett's esophagus, and family history of Barrett's esophagus and cancers, was collected at six hospitals using a structured questionnaire from probands with either long-segment Barrett's esophagus, adenocarcinoma of the esophagus, or adenocarcinoma of the gastroesophageal junction. Family history of Barrett's esophagus or esophageal cancer in a first- or second-degree relative was determined by reviewing medical records of all relatives reported to be affected.

Results: Seventy one of 411 (17.3%) probands reported an affected first- and/or second-degree relative. Upon review of medical records of the reportedly affected relatives, familial Barrett's esophagus was definitively determined in the case of 30 (7.3%) probands comprising 17 of 276 (6.2%) with Barrett's esophagus, 11 of 116 (9.5%) with adenocarcinoma of the esophagus, and 2 of 21 (9.5%) with adenocarcinoma of the gastroesophageal junction. The diagnosis in the relative reported by the proband to be affected was found not to be Barrett's esophagus or adenocarcinoma in 15 (3.6%) cases. The diagnosis could not be determined in 26 (6.3%) cases in which the proband reported an affected relative. There were no significant differences in age of disease onset, gender, race, or gastroesophageal reflux symptoms between definitive familial Barrett's esophagus probands and nonfamilial probands.

Conclusion: Familial Barrett's esophagus can be confirmed in 7.3% of persons presenting with Barrett's esophagus, adenocarcinoma of the esophagus, or adenocarcinoma of the gastroesophageal junction. (Cancer Epidemiol Biomarkers Prev 2006;15(9):1668–73)