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News

Barrett's esophagus and esophageal cancer is levelling off in Europe

Barrett's esophagus and esophageal adenocarcinoma in the United Kingdom and the Netherlands is levelling off, reports the latest issue of the Alimentary Pharmacology & Therapeutics.

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Barrett's esophagus is a risk factor for esophageal adenocarcinoma.

Several studies report increasing incidences of Barrett's esophagus with substantial variation.

Dr Masclee and colleagues from the Netherlands determined age- and sex-stratified incidence rates of Barrett's esophagus and esophageal adenocarcinoma.

The team performed a cohort study using 2 primary care databases in the United Kingdom and the Netherlands.

Barrett's esophagus and esophageal adenocarcinoma cases were identified using disease-specific READ codes, and free-text search with manual validation.

Age- and sex-specific incidence rates were calculated for both Barrett's esophagus and esophageal adenocarcinoma.
Incident rates of Barrett's was 2–4 times higher in males across all age groups
Alimentary Pharmacology & Therapeutics

From the study population of 6,885,420 subjects in the UK, the team identified 12,312 incident Barrett's esophagus, and 40 subsequent incident esophageal adenocarcinoma cases.

There were 1383 incident Barrett's esophagus, and subsequent 5 incident esophageal adenocarcinoma cases among the 1,487,191 subjects in the Netherlands.

The team found that the incident rate of Barrett's esophagus increased linearly with age, and was 16 per 100,000 PYs in the United Kingdom, and 24 per 100,000 PYs in the Netherlands for patients aged 40–44 years, increasing to 86 per 100,000 PYs in the United Kingdom, and 87 per 100,000 PYs in the Netherlands for 70–74 years.

In both the United Kingdom and the Netherlands, incident rates of Barrett's esophagus was 2–4 times higher in males than females across all age groups.

The team observed that with respect to calendar time, the incident rate of Barrett's esophagus increased by 35% in the United Kingdom, and 41% in the Netherlands from 2000 to 2003, after which incident rates remained stable until 2012.

Dr Masclee's team concludes, "The incidence rates of Barrett's esophagus in the United Kingdom and the Netherlands increased until 2003, but levelled off thereafter."

"Around 0.3% of patients with Barrett's esophagus developed esophageal adenocarcinoma at least 1 year after Barrett's esophagus diagnosis. "

"These findings may help tailor endoscopic surveillance strategies among patients with Barrett's esophagus."

Aliment Pharmacol Ther 2014: 39(11): 1321–1330
22 May 2014

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