Blog | Thursday, February 2, 2012

QD: News Every Day--Add Barrett's to the list of conditions impacted by smoking

Barrett's esophagus patients who smoke tobacco are at twice the risk of developing advanced precancerous cells and twice the risk for developing esophageal cancer, according to a new study in Gastroenterology.

Tobacco, not alcohol, was the strongest lifestyle risk factor in Barrett's esophagus patients, the lead author commented. And, the risk was higher no matter how few cigarettes were smoked per day.

Researchers collected data from 1993 to 2005 on 3,167 Barrett's esophagus patients, representing 23,692 person-years of follow-up with a mean follow-up period of 7.5 years. In the study, 117 of the patients developed dysplasia or cancers of the esophagus or stomach. Current tobacco smoking was significantly associated with an increased risk of progression (hazard ratio [HR], 2.03; 95% confidence interval, 1.29 to 3.17) compared with never smoking, and across all strata of smoking intensity.

After adjustment for confounders, there was elevated risk for former smokers (HR, 1.53; 95% CI, 0.95 to 2.45) and for current smokers (HR, 1.83; 95% CI, 1.14 to 2.92.)

The number of cigarettes smoked per day was known for just over half of smokers in this cohort, and there was no additional increase in progression risk for those who smoked more than 20 cigarettes a day compared to less than that. Pipe smokers had an increased risk of progression after adjustment for potential confounders (HR, 2.18; 95% CI, 1.10 to 4.32), but cigar smokers did not, although less than 1% of the cohort reported using cigars. Current smoking of tobacco in any format was associated with a significantly doubled risk of progression to cancer or high-grade dysplasia compared with never smokers (HR, 2.07; 95% CI, 1.34 to 3.18).

Drinking more than 10 units of alcohol per week was not associated with the risk of progression compared with those who abstained (HR, 1.04; 95% CI, 0.60 to 1.78), nor was less alcohol consumption a factor. The type of alcohol didn't matter, but the authors noted that this information was only available for 15% of the cohort.