Long-term endoscopic surveillance for Barrett's esophagus in Japan: Multicenter prospective cohort study

Kazuaki Norita, Tomoyuki Koike, Masahiro Saito, Hirohiko Shinkai, Reiko Ami, Yasuhiko Abe, Naohiro Dairaku, Yoshifumi Inomata, Shoichi Kayaba, Fumitake Ishiyama, Tomoyuki Oikawa, Motoki Ohyauchi, Hirotaka Ito, Sho Asonuma, Tatsuya Hoshi, Katsuaki Kato, Shuichi Ohara, Yosuke Shimodaira, Kenta Watanabe, Tooru ShimosegawaAtsushi Masamune, Katsunori Iijima

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


Objects: Although a recent study showed the cancer incidence of Barrett's esophagus (BE) to be 1.2%/year in 251 patient-years in Japan, the long-term outcomes remain unclear. The present study estimated the cancer risk of BE in Japan using our original prospective multicenter cohort. Methods: A total of 98 patients with BE of maximum length of ≥2 cm were enrolled during the period of 2010–2012 and received at least one follow-up endoscopy over 5 years thereafter. Cancer incidence rates with 95% confidence interval for occurrence of esophageal adenocarcinoma (EAC) were calculated as the number of events divided by patient-years of follow-up and were expressed as %/year. Results: Overall, the median endoscopic follow-up period was 59.9 (first and third quartiles, 48.5–60.8) months, constituting a total of 427 patient-years of observation. Since two EAC cases developed, the cancer incidence was 0.47% (0.01%–1.81%)/year. The cancer incidence was 0.39% (−0.16% to 2.44%) in 232 patient-years and 0.31% (−0.13% to 1.95%)/year in 318 patient-years for 55 cases with specialized intestinal metaplasia and 70 with BE ≥3 cm (maximum), respectively. At the end of follow-up, 12 of 92 patients (13.0%) died, but none died from EAC. Conclusion: This is the largest prospective follow-up study with endoscopy to investigate the incidence of EAC in unequivocal BE with the maximum length of ≥2 cm in Japan. Although a further large-scale study will be required to validate our results, the cancer risk of BE in Japan would be lower than previously reported (0.47% vs 1.2%/year).

Original languageEnglish
Pages (from-to)1085-1092
Number of pages8
JournalDigestive Endoscopy
Issue number7
Publication statusPublished - 2021 Nov


  • Barrett's esophagus
  • endoscopic surveillance
  • esophageal adenocarcinoma
  • incidence of cancer

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology


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