Alcohol Types and Sociodemographic Characteristics as Risk Factors for Barrett's Esophagus

Received 22 August 2008; accepted 20 November 2008. published online 28 November 2008.

Refers to article:

Continuing Medical Education Exam 2, March 2009 , 23 January 2009
Gastroenterology
March 2009 (Vol. 136, Issue 3, Pages 1105-1106)
Full-Text PDF (87 KB)

Background & Aims

Little is known about the effects of alcohol use and sociodemographics on the risk of Barrett's esophagus, a precursor to esophageal adenocarcinoma. We evaluated the association between alcohol use, alcohol type, sociodemographic profiles, other lifestyle factors, and the risk of Barrett's esophagus.

Methods

With the use of a case-control study within the Kaiser Permanente Northern California membership, patients with a new diagnosis of Barrett's esophagus (n = 320) diagnosed between 2002 and 2005 were matched to persons with gastroesophageal reflux disease (GERD; n = 316) and to population controls (n = 317). We collected information using validated questionnaires during direct in-person interviews. Analyses used multivariate unconditional logistic regression.

Results

Total alcohol use was not significantly associated with the risk of Barrett's esophagus, although stratification by beverage type showed an inverse association for wine drinkers compared with nondrinkers (≥7 drinks of wine per week vs none: odds ratio, 0.44; 95% confidence interval, 0.20–0.99; multivariate analysis). Among population controls, those who preferred wine were more likely to have college degrees and regularly take vitamin supplements than those who preferred beer or liquor, although adjustment for these factors or GERD symptoms did not eliminate the inverse association between wine consumption and Barrett's esophagus. Education status was significantly inversely associated with the risk of Barrett's esophagus.

Conclusions

There are associations between alcohol types, socioeconomic status, and the risk of Barrett's esophagus. Although choice of alcoholic beverages was associated with several factors, multiple adjustments (including for GERD) did not eliminate the association between alcohol and Barrett's esophagus. Further research to evaluate the associations among socioeconomic status, GERD, and Barrett's esophagus is warranted.

Abbreviations used in this paper: BMI, body mass index, CI, confidence interval, GERD, gastroesophageal reflux disease, ICD-9, International Classification of Diseases, Ninth Revision, KPNC, Kaiser Permanente, Northern California, NSAID, nonsteroidal anti-inflammatory drug, OR, odds ratio

⁎ Division of Research, Kaiser Permanente, Oakland, California

‡ School of Public Health, University of California, Berkeley, Berkeley, California

§ Department of Medicine, University of California, San Francisco, San Francisco, California

Reprint requests Address requests for reprints to: Ai Kubo, PhD, Kaiser Permanente Division of Research, 2000 Broadway, Oakland, California 94612. fax: (510) 891-3606

This article has an accompanying continuing medical education activity on page 1105. Learning Objective—At the end of this activity, the successful learner should be able to identify major known risk factors of Barrett's esophagus and esophageal adenocarcinoma.

Conflicts of interest The authors disclose no conflicts.

Funding Supported by National Institutes of Health grants K08DK002697 and RO1 DK63616, and a Kaiser Permanente/Permanente Medical Group Community Benefits grant.

PII: S0016-5085(08)02073-8

doi:10.1053/j.gastro.2008.11.042

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