P0633 - Assessment of Major Risk Factors Influencing the Presence of Dysplasia in Patients with Barrett's Esophagus in Mexican Population

Cristian Alexis Oviedo Garza, MD¹, Martin Antonio Manrique, MD², Ernesto Pérez Valle, MD², Miguel Angel Chavez Garcia, MD², Jony Cerna Cardona, MD³, Ma. Guadalupe Martinez Galindo, MD², Alejandra Diaz Garcia, MD², Luis Fernandez Garza, MD⁴, Arturo Ortiz, MD⁵, Rodrigo Vazquez Perez, MD², Maria Isabel Astudillo Delgado, MD², Scherezada M. I. Mejia Loza, MD², Rodrigo Guirao Perez, MD², Alexis Guillermo Martinez Cambranes, MD², Monica Angulo, MD², Jesus Ignacio Mazadiego Cid, MD², Antonio Alonso Ramirez y Ramirez, MD², Edgar Garcia, MD⁶, Maria de Los Angeles Calderon Gonzalez, MD², Sharon Selene Gaytan Montoya, MD², Teofilo Perez Corona, MD²
1Hospital Juarez de México, Mexico City, Distrito Federal, Mexico; 2Hospital Juarez de México, CDMX, Distrito Federal, Mexico; 3Gastroenterology Consultants, Mexico City, Distrito Federal, Mexico; 4IMSS, Monterrey, Nuevo Leon, Mexico; 5Universidad Autonoma de Tamaulipas, Matamoros, Tamaulipas, Mexico; 6Clinical pathology laboratories, Matamoros, Tamaulipas, Mexico

Introduction: In developed countries, esophageal adenocarcinoma (EAC) has emerged as the predominant histologic subtype, mirroring significant lifestyle and environmental shifts that are reshaping global incidence trends. This malignancy typically originates in the distal esophagus through a well-defined sequence from Barrett's esophagus (BE) to dysplasia and, ultimately, invasive carcinoma. Because EAC is usually diagnosed at an less treatable stage, advancing this understanding is critical to optimizing targeted screening strategies to improve early detection, when therapeutic interventions are most effective.

Methods: We included patients with a diagnosis of BE, confirmed through both endoscopic visualization and histopathological analysis, who were evaluated at the Gastrointestinal Endoscopy Unit of Hospital Juárez de México between 2023-2025. The tests used for group comparison were chi-square, Student's t-test, and Mann-Whitney U test. Finally, a binary logistic regression was performed, and a p-value of < 0.05 was taken as statistically significant.

Results: Of 81 patients, 50 (61%) were male, with a mean age of 59.5 ± 12.9 years. A history of smoking was present in 45 patients (55%), and 57 (70%) reported symptoms of gastroesophageal reflux disease (GERD). Endoscopic evaluation revealed median Prague C and M scores of 2 (1–3) and 4 (3–6), respectively; nodularity was observed in 23 patients (28%), and hiatal hernia in 47 (58%). Biopsy showed dysplasia in 26 patients (32%) and EAC in 7 (8%). Compared to patients without dysplasia, those with dysplasia had significantly higher rates of smoking, greater pack-year exposure, and more frequent co-occurrence of smoking and GERD symptoms. Binary logistic regression identified independent risk factors for dysplasia: smoking (OR = 4.61, 95% CI 1.48–14.29, p = 0.008), >30 pack-years (OR = 9.94, 95% CI 3.09–31.98, p < 0.001), and combined smoking and GERD symptoms (OR = 3.00, 95% CI 1.10–8.18, p = 0.033).

Discussion: Endoscopic screening is recommended for GERD patients with additional risk factors: male sex, age >50, obesity, or smoking as part of BE surveillance. In our Mexican cohort, GERD symptoms alone wasn't linked to dysplasia, but smoking combined with GERD symptoms tripled dysplasia risk. Moreover, smoking alone was associated with a fourfold increase, and up to tenfold with over 30 pack-years. These findings highlight smoking as the strongest modifiable risk factor for BE progression, emphasizing the urgent need for targeted cessation strategies.

Disclosures:
Cristian Alexis Oviedo Garza indicated no relevant financial relationships.
Martin Antonio Manrique indicated no relevant financial relationships.
Ernesto Pérez Valle indicated no relevant financial relationships.
Miguel Angel Chavez Garcia indicated no relevant financial relationships.
Jony Cerna Cardona indicated no relevant financial relationships.
Ma. Guadalupe Martinez Galindo indicated no relevant financial relationships.
Alejandra Diaz Garcia indicated no relevant financial relationships.
Luis Fernandez Garza indicated no relevant financial relationships.
Arturo Ortiz indicated no relevant financial relationships.
Rodrigo Vazquez Perez indicated no relevant financial relationships.
Maria Isabel Astudillo Delgado indicated no relevant financial relationships.
Scherezada M. I. Mejia Loza indicated no relevant financial relationships.
Rodrigo Guirao Perez indicated no relevant financial relationships.
Alexis Guillermo Martinez Cambranes indicated no relevant financial relationships.
Monica Angulo indicated no relevant financial relationships.
Jesus Ignacio Mazadiego Cid indicated no relevant financial relationships.
Antonio Alonso Ramirez y Ramirez indicated no relevant financial relationships.
Edgar Garcia indicated no relevant financial relationships.
Maria de Los Angeles Calderon Gonzalez indicated no relevant financial relationships.
Sharon Selene Gaytan Montoya indicated no relevant financial relationships.
Teofilo Perez Corona indicated no relevant financial relationships.

Cristian Alexis Oviedo Garza, MD¹, Martin Antonio Manrique, MD², Ernesto Pérez Valle, MD², Miguel Angel Chavez Garcia, MD², Jony Cerna Cardona, MD³, Ma. Guadalupe Martinez Galindo, MD², Alejandra Diaz Garcia, MD², Luis Fernandez Garza, MD⁴, Arturo Ortiz, MD⁵, Rodrigo Vazquez Perez, MD², Maria Isabel Astudillo Delgado, MD², Scherezada M. I. Mejia Loza, MD², Rodrigo Guirao Perez, MD², Alexis Guillermo Martinez Cambranes, MD², Monica Angulo, MD², Jesus Ignacio Mazadiego Cid, MD², Antonio Alonso Ramirez y Ramirez, MD², Edgar Garcia, MD⁶, Maria de Los Angeles Calderon Gonzalez, MD², Sharon Selene Gaytan Montoya, MD², Teofilo Perez Corona, MD². P0633 - Assessment of Major Risk Factors Influencing the Presence of Dysplasia in Patients with Barrett's Esophagus in Mexican Population, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.