 Factors predicting the development of dysplasia and cancer in BE patients are unknown. A few possible factors have been associated with esophageal adenocarcinoma, but not studied in BE patients. These include GERD symptoms, obesity, diet, smoking, prior cholecystectomy, drugs and H pylori infection negative association 25-36. The presence of hiatal hernia and BE length have been associated with dysplasia and cancer development in BE patients in a preliminary single center study 37. Reflux symptoms have also been reported to be significantly more prevalent among parents and siblings of patients with BE and esophageal adenocarcinoma than spouse control relatives 38. A few uncontrolled reports have provided conflicting results on the role of anti-reflux surgery and the use of acid suppressive medications proton pump inhibitors, H2 receptor antagonists and their effect on the neoplastic progression in BE patients 39-43. However, all the studies to date in BE patients have been limited by small sample sizes, univariate analysis, short duration of follow-up, lack of adjustment for confounding variables etc. In this proposed study, risk factors and mechanisms of capturing data at each site and data transfer to the main study database will be discussed and implemented. Sample size calculations for appropriate univariate and multiple logistic regression analysis will be performed. 