Nature Medicine, Published online: 23 April 2026; doi:10.1038/s41591-026-04332-7
We integrated large-scale epidemiological and genomic data from patients with esophageal adenocarcinoma to compare cancers with and without Barrett’s esophagus (BE). We found shared risk factors, molecular features, evolutionary trajectories and BE lineage markers in both cancer phenotypes. Our findings support a single intestinal metaplasia-mediated pathway and have direct implications for early detection and prevention strategies.
