ArticlePloS one2013
The role of tobacco, alcohol, and obesity in neoplastic progression to esophageal adenocarcinoma: a prospective study of Barrett's esophagus.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 6 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
50 citing papers in PubMed, 6 syntheses or guidelines pooled it, 99 citations in OpenAlex.
- Lifestyle, WCRF/AICR Recommendations, and Esophageal Adenocarcinoma Risk: A Systematic Review of the Literature.Nutrients · 2021Pooled it
- An update of the WCRF/AICR systematic literature review and meta-analysis on dietary and anthropometric factors and esophageal cancer risk.Annals of oncology : official journal of the European Society for Medical Oncology · 2017Pooled it
- Abdominal obesity and gastroesophageal cancer risk: systematic review and meta-analysis of prospective studies.Bioscience reports · 2017Pooled it
- Abnormal MGMT promoter methylation may contribute to the risk of esophageal cancer: a meta-analysis of cohort studies.Tumour biology : the journal of the International Society for Oncodevelopmental Biology and Medicine · 2014Pooled it
- Alcohol consumption and the neoplastic progression in Barrett's esophagus: a systematic review and meta-analysis.PloS one · 2014Pooled it
- Central adiposity is associated with increased risk of esophageal inflammation, metaplasia, and adenocarcinoma: a systematic review and meta-analysis.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2013Pooled it
- Effect of smoking-related features and 731 immune cell phenotypes on esophageal cancer: a two-sample and mediated Mendelian randomized study.Frontiers in immunology · 2024Trial
- Pathophysiology and perioperative dystrophy of esophagus cancer: association with malnutrition.Translational cancer research · 2025Review
- The Effect of Opioid Use on Esophageal Cancer: A Systematic Review and Meta-analysis.Addiction & health · 2025Review
- Long-term survival and risk factors in esophageal squamous cell carcinoma: A Kaplan-Meier and cox regression study.World journal of gastrointestinal surgery · 2024Article
- Exploring Dietary Factors and Esophageal Adenocarcinoma: Insights From Mendelian Randomization Study.Food science & nutrition · 2024Article
- Mortality burden and future projections of major risk factors for esophageal cancer in China from 1990 to 2019.General thoracic and cardiovascular surgery · 2024Article
- Mutational signature dynamics shaping the evolution of oesophageal adenocarcinoma.Nature communications · 2023Article
- Cigarette Smoke Enhances the Malignant Phenotype of Esophageal Adenocarcinoma Cells by Disrupting a Repressive Regulatory Interaction Between miR-145 and LOXL2.Laboratory investigation; a journal of technical methods and pathology · 2023Article
- Evolution and progression of Barrett's oesophagus to oesophageal cancer.Nature reviews. Cancer · 2021Review
- Barrett's esophagus surveillance in a prospective Dutch multi-center community-based cohort of 985 patients demonstrates low risk of neoplastic progression.United European gastroenterology journal · 2021Article
- Global burden and epidemiology of Barrett oesophagus and oesophageal cancer.Nature reviews. Gastroenterology & hepatology · 2021Review
- Epidemiology of Barrett's Esophagus and Esophageal Adenocarcinoma: Implications for Screening and Surveillance.Gastrointestinal endoscopy clinics of North America · 2021Review
- Lifestyle Risk Factors, Quality of Life, and Intervention Preferences of Barrett's Esophagus Patients: A Prospective Cohort Study.Global advances in health and medicine · 2021Article
- Gut Microbiota for Esophageal Cancer: Role in Carcinogenesis and Clinical Implications.Frontiers in oncology · 2021Review
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundEsophageal adenocarcinoma (EA) incidence in many developed countries has increased dramatically over four decades, while survival remains poor. Persons with Barrett's esophagus (BE), who experience substantially elevated EA risk, are typically followed in surveillance involving periodic endoscopy with biopsies, although few progress to EA. No medical, surgical or lifestyle interventions have been proven to safely lower EA risk.
designWe investigated whether smoking, obesity or alcohol could predict progression to EA in a prospective cohort of 411 BE patients. Data were collected during personal interview. Adjusted hazard ratios (HR) were estimated using Cox regression.
results39% had body mass index (BMI) over 30 and 64% had smoked cigarettes. Main analyses focused on those with at least 5 months of follow-up (33,635 person-months), in whom 45 developed EA. Risk increased by 3% per year of age (trend p-value 0.02), with approximate doubling of risk among males. EA risk increased with smoking pack-years (trend p-value 0.04) and duration (p-value 0.05). Compared to never-smokers, the HR for those in the highest pack-year tertile was 2.29 (95%CI 1.04-5.07). No association was found with alcohol or BMI, whereas a suggestion of increased risk was observed in those with higher waist-hip ratio, especially among males.
conclusionEA risk significantly increased with increasing age and cigarette exposure. Abdominal obesity, but not BMI, was associated with a modest increased risk. Continued follow-up of this and other cohorts is needed to precisely define these relationships so as to inform risk stratification and preventive interventions.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.