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Esophageal Columnar Metaplasia in Childhood: A Population-Based Case Series Analysis

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Abstract

Background

Adults with Barrett’s esophagus (BE) are often entered into surveillance for esophageal adenocarcinoma (EAC), although cancer risk is relatively low. BE can be detected in children (< 16 years). Little is known about the epidemiology of pediatric BE, and it is unclear what the optimal surveillance regimes are in children.

Aim

To evaluate the demographic and clinical characteristics, and future neoplastic progression risk in all pediatric BE patients diagnosed in Northern Ireland between 1993 and 2010.

Methods

Data from the population-based Northern Ireland BE register were matched to the Northern Ireland Cancer Registry for EAC outcomes until end 2013. Age-adjusted incidence of pediatric BE was calculated, and characteristics between pediatric and adult BE patients compared using Chi-square tests.

Results

Over 18 years, 42 pediatric BE patients (< 16 years) were identified, equivalent to an age-adjusted incidence of < 2 per 100,000 children. There was a clear age differential, with BE incidence increasing with age within the pediatric population. The majority (85.7%) of patients were male, a significantly higher male/female ratio than adult BE patients (p < 0.001). No pediatric BE patients progressed to high-grade dysplasia (HGD) or EAC, although the eldest patient was aged 34 years by the end of follow-up.

Conclusions

This is the largest series of pediatric BE ever reported. It demonstrates that pediatric BE is rare. The male preponderance of this condition is more apparent in childhood compared with adult cases. No children developed HGD/EAC during follow-up, suggesting that regular surveillance is not required, at least until adulthood.

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Acknowledgments

This research has been conducted using data from the Northern Ireland Cancer Registry which is funded by the Public health Agency from NI. However, the interpretation and conclusions of the data are the sole responsibility of the author(s). The author(s) acknowledge the contribution of the NICR staff in the production of the NICR data. Like all Cancer Registries our work uses data provided by patients and collected by the Health service as part of their care and support.

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Author notes

  1. Liam J. Murray: Deceased January 12th 2018.

Authors and Affiliations

  1. Centre for Public Health, Queen’s University Belfast, Belfast, Northern Ireland, UK

    Leah Twohig-Bennett, Helen G. Coleman, Victoria Cairnduff, Liam J. Murray & Anna T. Gavin

  2. Department of Pathology, Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK

    Damian T. McManus

  3. Northern Ireland Cancer Registry, Belfast, Northern Ireland, UK

    Anna T. Gavin

  4. Department of Gastroenterology, Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK

    Brian T. Johnston

Authors
  1. Leah Twohig-Bennett
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  2. Helen G. Coleman
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  3. Victoria Cairnduff
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  4. Damian T. McManus
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  5. Liam J. Murray
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  6. Anna T. Gavin
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  7. Brian T. Johnston
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Correspondence to Brian T. Johnston.

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All the authors have no conflicts of interest regarding this paper.

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Twohig-Bennett, L., Coleman, H.G., Cairnduff, V. et al. Esophageal Columnar Metaplasia in Childhood: A Population-Based Case Series Analysis. Dig Dis Sci 66, 2317–2322 (2021). https://doi.org/10.1007/s10620-020-06462-5

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  • DOI: https://doi.org/10.1007/s10620-020-06462-5

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