TOPLINE:

An analysis using molecular clock modeling of data from Barrett esophagus (BE) tissue samples revealed that the biological onset of BE occurred at a median age of approximately 29 years, which is more than 20 years before the recommended screening age of 50 years. Female patients experienced a later onset of BE than male patients in two independent cohorts.

METHODOLOGY:

• Screening for BE is recommended to start at the age of 50 years for individuals who have additional risk factors; however, the exact age of the biological onset of BE in individual patients is largely unknown.
• Researchers applied a BE molecular clock model to methylation data from formalin-fixed, paraffin-embedded biopsy samples of patients with incident BE to estimate the age at which BE first developed in individual patients.
• A total of 174 patients were analyzed from two independent cohorts: 34 patients from the Northern Ireland Barrett’s Oesophagus Register (NIBR; 69.1% male) and 140 patients from the Oesophageal Cancer Clinical and Molecular Stratification UK consortium and the Cambridge Barrett’s bioresource (Cambridge cohort; 84.1% male).
• Additionally, 49 normal gastric or squamous esophageal tissue samples were obtained to estimate tissue age.
• Bayesian modeling was applied to patient-specific methylation data to predict the age of onset of BE.

TAKEAWAY:

• The median age of onset of BE was 29.5 years in the NIBR cohort and 29.3 years in the Cambridge cohort.
• In the NIBR cohort, the median age of onset of BE in female patients was 43.3 years, which was 15 years later than that observed in male patients (28.3 years; P = .18).
• In the Cambridge cohort, the median age of onset of BE in female patients was 33.5 years compared with 28.6 years in male patients, representing a 4.9-year difference (P = .16).

IN PRACTICE:

“Our modeling suggests that BE biological onset occurred over two decades before the recommended screening age of 50 in the majority of the two independent cohorts, indicating that most cases could be identified with sensitive, targeted screening,” the authors of the study wrote.

SOURCE:

The study was led by Kit Curtius, Bioinformatics and Systems Biology, University of California, San Diego, and was presented at Digestive Disease Week (DDW) 2026 in Chicago.

LIMITATIONS:

No limitations were discussed in the abstract.

DISCLOSURES:

No funding sources or conflict of interest statements are provided in the abstract.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.