Barrett's esophagus is traditionally thought of as a disease of middle-aged Caucasian men.
Little is known about Barrett's esophagus in younger patients.
Dr Gary Falk and colleagues from Ohio assessed the effect of age on features of Barrett's esophagus.
The team of doctors evaluated the prevalence and incidence of dysplasia and carcinoma.
The doctors studied all patients enrolled into the Cleveland Clinic Barrett's esophagus registry from 1979 to 2002.
The team compared age, ethnicity, number of endoscopies, hiatal hernia size, and length of Barrett's segment between patient over and under the age of 50 years.
Prevalence and incidence of dysplasia, and cancer were also compared between these patients.
|30 of 225 patients with cancer were under 50 years of age|
|American Journal of Gastroenterology|
There were 837 patients in the registry, of which 638 were 50 years or older, and 199 were 50 years or younger.
Hiatal hernia size was larger in patients over 50 years than in those under 50 years.
Otherwise, the doctors found no significant differences among other features in the patient population.
The team identified 225 patients with dysplasia or cancer, of which 195 were over 50 years and 30 were under 50 years of age.
Of this group, the team noted 176 prevalent cases, with 159 over 50 years and 17 under 50 years of age.
The doctors found that 49 patients with dysplasia were incident cases, of which 36 were over 50 years and 13 were under 50 years.
The odds of those over 50 years being a prevalent case of high-grade dysplasia or cancer was 5 times the odds of those under 50 years.
The incidence of dysplasia or cancer was similar in both age groups.
Dr Falk's team concludes, “Our study supports emerging data that approximately 25% of Barrett's esophagus patients are less than 50 years of age.”
“While older patients had a higher prevalence of dysplasia or adenocarcinoma, the incidence of dysplasia and adenocarcinoma is similar in both age groups.”
“Future screening strategies for Barrett's esophagus should recognize these important findings.”