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 23 February 2018

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News

Is the length of newly diagnosed Barrett's esophagus decreasing?

There has been an overall decline in the length of newly diagnosed Barrett's esophagus due to an increase in short-segment Barrett's esophagus and a decline in long-segment Barrett's esophagus, find researchers in the Clinical Gastroenterology and Hepatology.

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In this study, researchers from the United States evaluated 340 patients with documented Barrett's esophagus (BE) diagnosed between 1981 and 2000.

The team examined the association between year of diagnosis and BE length. They adjusted for temporal differences in age, sex, ethnicity, previous use of antisecretory therapy, and the presence of intestinal metaplasia (IM) of the gastric cardia.

The team defined cases by the presence of areas of salmon-colored mucosa in the lower end of the tubular esophagus and IM in biopsy specimens.

They found that there were no significant changes over time in the mean age of patients with BE or in the proportion of white patients.
More recent year of diagnosis is a predictor of shorter Barrett's esophagus length.
Clinical Gastroenterology and Hepatology

However, the team determined that the mean length of BE at the time of first diagnosis declined progressively over time.

They found that in the 1981 to 1985 period the mean BE length was 6 cm, whereas mean BE length in the 1996 to 2000 period was 4 cm.

This was explained, not only by more frequent diagnoses of short BE, but also by less frequent diagnoses of long BE.

The team identified a strong inverse correlation between BE length at the time of diagnosis and year of diagnosis (Pearson’s correlation coefficient, –0.29).

Using multivariate linear regression, they found that a more recent year of diagnosis was an independent predictor of shorter BE length.

The researchers also obtained similar results in analyses restricted to veteran patients or those with BE ≥3 cm.

Dr Hashem El-Serag's team concluded, "There has been a progressive decline in the length of newly diagnosed BE as a result of an increase in short-segment BE, but, curiously, also because of a decline in long-segment BE (3 cm)".

"These changes cannot be explained fully by changes in demographic features of patients, previous therapy, or the increasing emphasis on IM of the gastric cardia".

"The role of referral bias and/or temporal changes in the definitions cannot be excluded".

Clinical Gastroenterology and Hepatology 2004; 2(4):
07 April 2004

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