The increased incidence and prevalence of clinically diagnosed Barrett's esophagus may be due to the increased use of endoscopy, although the majority of cases still remain undiagnosed, claim researchers from Minnesota, USA.
The team investigated the changes in the incidence, prevalence, and outcome of Barrett's esophagus in a defined population, and reported their findings in the March issue of Gut.
|Incidence of clinically diagnosed Barrett's esophagus has risen in parallel with the number of gastroscopic examinations.|
Residents of Olmsted County, Minnesota, were enrolled in the study if they had clinically diagnosed Barrett's esophagus, or an adenocarcinoma in the esophagus or esophagogastric junction.
The researchers found that the incidence of clinically diagnosed Barrett's esophagus (greater than 3 cm) increased 28-fold, from 0.37 per 100,000 person years in 1965-69 to10.5 per 100,000 in 1995-97. Gastroscopic examinations increased 22-fold in this same time period.
The prevalence of diagnosed Barrett's esophagus increased from 22.6 per 100,000 in 1987 to 82.6 per 100,000 in 1998. The prevalence of short segment Barrett's esophagus (less than 3 cm) in 1998 was 33.4 per 100,000.
Patients with Barrett's esophagus were found to have shorter than expected survival, but only one patient with the condition died from adenocarcinoma. In addition, only 4 of 64 adenocarcinomas occurred in patients with previously known Barrett's esophagus.
The incidence and prevalence of clinically diagnosed Barrett's esophagus have increased in parallel with the increased use of endoscopy, commented the authors.
Dr M. Conio, of the Mayo Foundation, Minnesota, concluded on behalf of the group, "We infer that the true population prevalence of Barrett's esophagus has not changed greatly, although the incidence of esophageal adenocarcinoma increased 10-fold.
"Many adenocarcinomas occurred in patients without a previous diagnosis of Barrett's esophagus, suggesting that many people with this condition remain undiagnosed in the community."