427. CAN WE OPTIMIZE THE RECOMMENDATIONS FOR FOLLOW-UP OF BARRETT’S ESOPHAGUS THROUGH CRITICAL ANALYSIS OF RISK FACTORS IN A SPECIFIC POPULATION?

Abstract Introduction Barrett’s esophagus (BE) affects approximately 3 million people in Brazil with its incidence has been increasing in recent years. In this pathology, the genetically unstable metaplastic epithelium leads to risks of progression to dysplasia and esophageal adenocarcinoma (EAC). In a scenario where most EACs arise in the presence of BE, it is necessary to study the epidemiological risk factors associated with this evolution to implement optimized surveillance recommendations. Objective Evaluate the epidemiological risk factors involved in the development of dysplasia and adenocarcinoma from BE in a specific population and propose an appropriate suggestion on how to carry out the follow-up according to these factors. Methodology A retrospective cross-sectional study was conducted in a tertiary center with patients with BE followed in this center. Patients with BE who presented adenocarcinoma and/or dysplasia were compared to those who did not, considering the variables gender, age, smoking, BMI, ethnicity, and extent of Barrett’s. Logistic regression was performed to measure the odds ratio (OR) between risk factors for the outcome of adenocarcinoma and the outcome of dysplasia. Finally, the presence of proven epidemiological risk factors in this population was correlated with the time of development of EAC from BE. Results There was a statistically significant difference between smoking, race, gender, extent of Barrett’s, and age among patients that presented adenocarcinoma and not. Smokers and ex-smokers had a 4.309 times higher risk of developing adenocarcinoma, and the extent of Barrett’s increased this risk by 1.193 times per centimeter. Among the group that presented dysplasia compared to the group that did not, smoking, the extent of Barrett’s, and age were statistically significant, with the extent of Barrett’s increasing the risk of developing dysplasia by 1.128 times per centimeter and age increased the risk of this outcome by 1.023 per year. Patients without risk factors did not develop EAC in less than 12 months, even if they had dysplasia before. Conclusion The study confirmed a higher risk of developing dysplasia and adenocarcinoma in specific epidemiological groups, which can redirect follow-up in patients with BE in a more cost-effective manner.