Sex Differences in Neoplastic Progression in Barrett's Esophagus:A Multicenter Prospective Cohort Study

Recommendations in Barrett’s esophagus (BE) guidelines are mainly based on male patients. We aimed to evaluate sex differences in BE patients in (1) probability of and (2) time to neoplastic progression, and (3) differences in the stage distribution of neoplasia. We conducted a multicenter prospective cohort study including 868 BE patients. Cox regression modeling and accelerated failure time modeling were used to estimate the sex differences. Neoplastic progression was defined as highgrade dysplasia (HGD) and/or esophageal adenocarcinoma (EAC). Among the 639 (74%) males and 229 females that were included (median follow-up 7.1 years), 61 (7.0%) developed HGD/EAC. Neoplastic progression risk was estimated to be twice as high among males (HR 2.26, 95% CI 1.11–4.62) than females. The risk of HGD was found to be higher in males (HR 3.76, 95% CI 1.33–10.6). Time to HGD/EAC (AR 0.52, 95% CI 0.29–0.95) and HGD (AR 0.40, 95% CI 0.19–0.86) was shorter in males. Females had proportionally more EAC than HGD and tended to have higher stages of neoplasia at diagnosis. In conclusion, both the risk of and time to neoplastic progression were higher in males. However, females were proportionally more often diagnosed with (advanced) EAC. We should strive for improved neoplastic risk stratification per individual BE patient, incorporating sex disparities into new prediction models

Additional file 5: of Prognostic DNA methylation markers for sporadic colorectal cancer: a systematic review

Table S5. Risk of potential bias and confounders of the included studies. Studies indicated by a “X” potentially have an increased risk of bias, whereas studies indicated by a “√” potentially have a decreased risk of bias. (DOCX 108 kb

Additional file 4: of Prognostic DNA methylation markers for sporadic colorectal cancer: a systematic review

Table S4. Scoring of 83 included studies according to REMARK. (DOCX 114 kb

Additional file 6: of Prognostic DNA methylation markers for sporadic colorectal cancer: a systematic review

Table S6. Single markers and their characteristics that have been investigated in more than one study series, however, of which Cox regression survival analysis was not available for all markers. (DOCX 63 kb