Mortality rates in patients with Barrett’s oesophagus

BACKGROUND: Patients with Barrett's oesophagus are at increased risk of oesophageal adenocarcinoma. Observational studies have suggested increase in overall mortality also but data are conflicting. AIM: To assess the cause of death in patients with Barrett's oesophagus compared with the general population. METHODS: Patients with Barrett's oesophagus were identified retrospectively in four hospitals in Leicestershire, UK using electronic endoscopy and histopathology records from 1997 to 2003. Data on deaths from this cohort of patients were identified through the Office of National Statistics and compared with age- and gender-adjusted mortality in the Leicestershire region. RESULT: In all, 1272 Barrett's patients were identified with 245 deaths in this cohort. Overall mortality was found to be increased [male standardized mortality ratio (SMR) = 552, 95% CI = 466-638; female SMR 455, 95% CI = 357-552]. The main disease areas that were responsible for this increase were oesophageal adenocarcinoma (n = 25, male SMR = 2171, 95% CI = 991-3351; female SMR = 1300, 95% CI = 26-2574), bronchopneumonia (n = 70, male SMR = 146, 95% CI = 55-236; female SMR = 436, 95% CI = 272-601) and ischaemic heart disease (n = 51, male SMR = 186, 95% CI = 97-2748; female SMR = 205, 95% CI = 105-306). CONCLUSIONS: Patients with Barrett's oesophagus die more commonly of bronchopneumonia and ischaemic heart disease compared with oesophageal adenocarcinoma, and overall mortality in this group may be increased.