Esophageal Cancer Risk Doubled For Barrett's Patients Who Smoke

Barrett's esophagus patients who routinely smoke tobacco face a doubled risk of developing esophageal cancer, according to a new study in the journal Gastroenterology. These patients who smoke also double their risk for developing advanced precancerous cells or dysplasia.

According to lead author, Helen Coleman, PhD, "We found that tobacco smoking emerged as the strongest lifestyle risk factor for cancer progression. Contrary to popular belief, alcohol consumption didn't increase cancer risk in this group of patients with Barrett's esophagus.”

While analyzing data (ranging from 1993 to 2005) from a population-based cohort of more than 3,000 worldwide Barrett’s esophagus patients, doctors discovered that by 2008, 117 of the patients had developed dysplasia or cancers of the esophagus or stomach. For the first time in a study of this scope, researchers were able to attain information about smoking at the time a person was initially diagnosed with Barrett’s esophagus to observe how this influenced cancer risk years later.

Current tobacco smoking, regardless of the amount of daily cigarettes, was significantly associated with an increased risk of esophageal cancer. This suggests that decreasing the number of cigarettes smoked each day may not lower the risk of cancer in BE patients.

The incidence of esophageal cancer is on the rise in developed countries. Barrett’s esophagus is a precursor to cancer and is likely responsible for its progression through developing precancerous cells. However, progression along this pathway is not common, and the greater majority of Barrett’s esophagus patients never develop esophageal cancer or high-grade dysplasia.  

Dr. Coleman adds, "Tobacco smoking has been long established as highly carcinogenic. Barrett's esophagus patients who smoke should start a cessation program immediately."

Although these findings need to be confirmed further in future studies, the study’s researchers suggest that tobacco smoking be discouraged and smoking-cessation strategies be considered for Barrett’s esophagus patients to prevent future risk of cancer. Additionally, determining modifiable lifestyle factors that impact cancer progression can provide a cost-effective means of slowing the cancer rate among this patient group.


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