{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:59:53Z","timestamp":1785373193078,"version":"3.55.0"},"reference-count":11,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["UEG Journal"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Esophageal adenocarcinoma (EAC) represents one of the most increasing malignancies in Western countries. The disease is multifactorial, involving modifiable risk factors and genetic susceptibility variants. These variants can be aggregated to a polygenic risk score (PRS) that reflects individual genetic risk. Investigation of the effects of lifestyle factors, PRS, and co\u2010medication on EAC age at onset (AAO) is critical for shaping prevention strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A detailed questionnaire was used to assess pre\u2010diagnostic exposure to lifestyle factors and clinical information from a large German EAC cohort. Linear regression analysis was performed to identify factors associated with EAC AAO in 1742 EAC patients. PRS was available for 1190 patients. Subgroup analyses were conducted to estimate the effects of the analyzed factors on AAO according to age group (early vs. late onset), sex, and prior diagnosis of Barrett's esophagus (BE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Earlier AAO was significantly associated with gastroesophageal reflux (GER), smoking and a higher PRS, whereas later AAO was associated with physical activity and higher consumption of fish and fruits. Among co\u2010medication, combined use of proton pump inhibitors (PPIs) and acetylsalicylic acid (ASA) showed the most significant effect on AAO, whereas the use of PPIs and ASA alone showed weaker effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This study represents the largest questionnaire\u2010based analysis to date investigating factors influencing EAC development. Our findings show that the combined use of PPIs and ASA, both cost\u2010effective medications, is associated with delayed EAC onset. In addition, lifestyle and genetics contribute to EAC AAO.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ueg2.70236","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T07:36:34Z","timestamp":1781163394000},"source":"Crossref","is-referenced-by-count":1,"title":["Clinical, Dietary, Lifestyle and Genetic Factors Associated With Age at Onset of Esophageal Adenocarcinoma"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-0588-4542","authenticated-orcid":false,"given":"Vera","family":"Koch","sequence":"first","affiliation":[{"name":"Center for Human Genetics Philipps University of Marburg &amp; University Hospital Marburg  Marburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ines","family":"Gockel","sequence":"additional","affiliation":[{"name":"Department of Visceral Surgery University Digestive Health Care Center Basel  Clarunis Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"Reingruber","sequence":"additional","affiliation":[{"name":"Center for Human Genetics Philipps University of Marburg &amp; University Hospital Marburg  Marburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Kreuser","sequence":"additional","affiliation":[{"name":"Department of Visceral Transplant Thoracic and Vascular Surgery University Hospital Leipzig  Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Bigge","sequence":"additional","affiliation":[{"name":"Center for Human Genetics Philipps University of Marburg &amp; University Hospital Marburg  Marburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8581-0974","authenticated-orcid":false,"given":"Marino","family":"Venerito","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Hepatology and Infectious Diseases Otto\u2010von\u2010Guericke University Hospital  Magdeburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hakan","family":"Alakus","sequence":"additional","affiliation":[{"name":"Department of General Visceral Cancer and Transplantation Surgery University Hospital of Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"May","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Oncology and Pneumology Asklepios Paulinen Klinik Wiesbaden  Wiesbaden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8271-1102","authenticated-orcid":false,"given":"Christian","family":"Gerges","sequence":"additional","affiliation":[{"name":"Department of Medicine II Helios Klinikum Krefeld  Krefeld Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ren\u00e9","family":"Thieme","sequence":"additional","affiliation":[{"name":"Department of Visceral Transplant Thoracic and Vascular Surgery University Hospital Leipzig  Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3108-8311","authenticated-orcid":false,"given":"Dominik","family":"Heider","sequence":"additional","affiliation":[{"name":"Institute of Medical Informatics University of M\u00fcnster  M\u00fcnster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel M.","family":"Hillmer","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and University Hospital Cologne Institute of Pathology University of Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alanna","family":"Ebigbo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology University Hospital of Augsburg  Augsburg Germany"},{"name":"Department of Internal Medicine St. Josef\u2010Hospital Ruhr\u2010University Bochum  Bochum Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiane J.","family":"Bruns","sequence":"additional","affiliation":[{"name":"Department of General Visceral Cancer and Transplantation Surgery University Hospital of Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hauke","family":"Lang","sequence":"additional","affiliation":[{"name":"Department for General Visceral and Tranplant Surgery University Medical Center of the Johannes Gutenberg\u2010University Mainz  Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helmut","family":"Messmann","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology University Hospital of Augsburg  Augsburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"R\u00f6sch","sequence":"additional","affiliation":[{"name":"Department of Interdisciplinary Endoscopy University Hospital Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thadd\u00e4us T.","family":"Wissniowski","sequence":"additional","affiliation":[{"name":"Center for Internal Medicine II Klinikum Chemnitz  Chemnitz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michaela","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Endocrinology Centre for Internal Medicine Philipps University of Marburg &amp; University Hospital Marburg  Marburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrike W.","family":"Denzer","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Endocrinology Centre for Internal Medicine Philipps University of Marburg &amp; University Hospital Marburg  Marburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus M.","family":"N\u00f6then","sequence":"additional","affiliation":[{"name":"Institute of Human Genetics University of Bonn School of Medicine &amp; University Hospital Bonn  Bonn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Vieth","sequence":"additional","affiliation":[{"name":"Institute of Pathology Friedrich\u2010Alexander\u2010Universi\u00e4t Erlangen\u2010N\u00fcrnberg Klinikum Bayreuth  Bayreuth Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0084-5308","authenticated-orcid":false,"given":"Aaron P.","family":"Thrift","sequence":"additional","affiliation":[{"name":"Section of Epidemiology and Population Sciences Department of Medicine Baylor College of Medicine  Houston Texas USA"},{"name":"Dan L Duncan Comprehensive Cancer Center Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Maj","sequence":"additional","affiliation":[{"name":"Center for Human Genetics Philipps University of Marburg &amp; 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