Diabetes, a component of metabolic syndrome, has previously been linked to Barrett’s esophagus — where the esophageal lining becomes similar to that of the stomach — but the prevalence of diabetes in patients with the esophageal disease has never been researched. Now, a new study has found that diabetes could double the risk of developing esophageal cancer in patients with Barrett’s esophagus.
“There has been a rising incidence of metabolic syndrome over the past decades, which seems to correlate with an increase in esophageal cancer,” lead researcher Prashanthi N. Thota, who presented the team’s findings at the annual meeting of the American College of Gastroenterology, told MedPage Today.
People develop Barrett’s esophagus when their esophageal muscles fail to close tightly enough, and allow gastric acid to enter the esophagus. When this happens, it can damage, and eventually change the lining of the esophagus. These changes can eventually cause dysplasia — an increased population of immature cells — and possibly even cancer.
Thota’s team of researchers looked at data from 1,623 patients who had Barrett’s esophagus and were seen between 2000 and 2013. Of these patients, 274 also had diabetes or were diagnosed with it during the duration of the study. After accounting for sex, race, and length of Barrett’s esophagus segment, the researchers found adenocarcinoma — cancer of the epithelium — in 15.8 percent of those without diabetes and 25.9 percent of those with diabetes during the 16-month follow-up. They also saw high-grade dysplasia or cancer in 17.9 percent of patients with diabetes compared to only 9.7 percent of those without.
Interestingly, the researchers also found that 61.9 percent of patients who had hypertension didn’t develop dysplasia compared to 56 percent of those who had hypertension — the researchers had expected the opposite. “I suspect that this relates to the use of antihypertensive drugs rather than the condition per se,” Thota told MedPage Today.
A 2012 study also found that diabetic men could have an increased risk for developing esophageal cancer. Looking at data from 17 other studies, the researchers concluded that diabetics had a “modestly increased risk” of esophageal cancer and adenocarcinomas, and that men were significantly more at risk.