Diabetes linked to higher risk of esophageal cancer

Tue, 15 Oct 2013
Diabetes could more than double the risk of esophageal cancer in patients with Barrett's esophagus, new research has found.

Barrett's esophagus is a condition that develops when the esophagus - the muscular tube that carries food and liquids from the mouth to the stomach - fails to close tightly enough and allows gastric acid to enter, causing damage and eventually changing the lining of the esophagus.

Due to these changes, people with Barrett's esophagus are at higher risk of progressing to dysplasia (an increased population of immature cells) and a rare form of cancer known as esophageal adenocarcinoma.

But now scientists in the US have found that the presence of diabetes appears to increase this risk further.

To investigate the prevalence of diabetes in patients with the esophageal disease, Prashanthi N. Thota, of the Cleveland Clinic, and colleagues analysed data from 1,623 Barrett's esophagus patients treated at Cleveland medical centre between 2000 and 2013. Of these patients, 274 also had diabetes or were diagnosed with diabetes during the course of the study.

After adjusting for sex, race, and length of Barrett's esophagus dianogis, the researchers found that 17.9% of those with diabetes progressed to high-grade dysplasia compared to just 9.7% of patients without diabetes during the 16-month follow-up, while quarter (25.95%) of diabetic patients developed esophageal adenocarcinoma compared with 15.8% of non-diabetics.

The researchers concluded: "Patients with DM (diabetes mellitus) have higher prevalence of Barrett's dysplasia/cancer. They also had more than two-fold higher risk of progression of dysplasia in BE (Barrett's esophagus)."

Thota said the observed increase in esophageal cancer may partly be due to a greater prevalence of metabolic syndrome - a group of metabolic conditions that occur together - among diabetes sufferers, but added that more research is needed to determine whether diabetes is an independent risk factor for progression to dysplasia or cancer in Barrett's esophagus.

The study findings were presented at the annual meeting of the American College of Gastroenterology.
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