Gastroesophageal reflux and Barrett's esophagus: a pathway to esophageal adenocarcinoma.

The incidence of esophageal adenocarcinoma (EAC) has increased significantly in Western countries. The rising prevalence of gastroesophageal reflux disease (GERD) and obesity has played a major role in the increasing numbers of EAC. Approximately 10-15% of patients with GERD will develop Barrett's esophagus (BE). This metaplastic transformation is due to the chronic injury produced by repeated reflux episodes and involves genetic mutations that can lead to a malignant transformation. Ultimately, the development of EAC is characterized by the sequence BE metaplasia-dysplasia-invasive carcinoma.