Objective To assess health-related quality of life in patients with non-dysplastic Barrett’s oesophagus (NDBO) and endoscopically treated dysplastic Barrett’s oesophagus (DBO).
Design This quantitative, self-administered questionnaire study was conducted across three National Health Service hospitals. Data were collected from three other cohorts; gastro-oesophageal reflux disease (GORD), colonic polyp surveillance and healthy individuals. Fisher’s exact and Spearman’s rank correlation tests were used for analysis. Propensity score matching adjusted for age, sex and comorbidities.
Results 687 participants were eligible for analysis (NDBO n=306, DBO n=49, GORD n=132, colonic polyps n=152 and healthy n=48). 53% of NDBO participants reported similarly high cancer worry, comparable to DBO (50%, p=0.933) and colonic polyp participants (51%, p=0.355). Less cancer worry was reported in GORD participants (43.4%, p=0.01 vs NDBO). NDBO participants reported anxiety in 15.8% and depression in 8.6% of cases, which was similar to the other disease cohorts. Moderate or severe heartburn or acid regurgitation was found in 11% and 10%, respectively, in the NDBO cohort, comparable to DBO participants (heartburn 2% p=0.172, acid regurgitation 4% p=0.31) but lower (better) than GORD participants (heartburn 31% p=<0.001, acid regurgitation 25% p=0.001). NDBO participants with moderate or severe GORD symptoms were associated with higher rates of anxiety (p=<0.001), depression (p=<0.001) and cancer worry (p=<0.001). NDBO patients appropriately perceiving their cancer risk as low had lower rates of cancer worry (p=<0.001).
Conclusion This study provides insight into the problems Barrett’s oesophagus patients may face. Future care pathways must be more patient focussed to address misconceptions of cancer risk, oesophageal cancer related worry and GORD symptom control.
- barrett’s oesophagus
- quality of life
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
Statistics from Altmetric.com
Contributors All authors significantly contributed to this work. The concept and design of this study was instigated by YA, JM and SH. This study forms part of a larger research project including preliminary qualitative work in collaboration with MH. JB, YA and RW were responsible for driving recruitment. Data analysis was conducted by JB, PT and GM. JB drafted the initial manuscript. All authors then had a role in revision of the manuscript prior to submission.
Funding This study forms part of a larger research project which has received unrestricted external funding support from Covidien (Medtronic). Covidien have not influenced the design of this study, writing of the manuscript or decision to submit for publication. (Medtronic, Grant/Award Number: ISR-2016-10773)
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval Prior ethical approval for this study was obtained from the Health Research Authority Yorkshire and Humber ethics committee (REC reference number 16/YH/0035).
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.