Brief report: the length of newly diagnosed Barrett's esophagus may be decreasing

Abstract

Few studies have examined the temporal trends of length in newly diagnosed Barrett's esophagus (BE) and arrived at conflicting results. The aim of this study was to identify whether there has been a change over time in the length of BE at the time of diagnosis. This is a retrospective, single-center, observational study from Houston, Texas on newly diagnosed BE between 2008 and 2013. All cases were defined by the presence of endoscopically visible BE and histologic confirmation of intestinalized columnar epithelium with goblet cells. The length of BE was measured using the Prague classification. We examined temporal changes in 1-year intervals in the length of BE at the time of diagnosis. Both the frequency and mean length of BE at diagnosis seemed to decrease over time from February 2008 to July 2013. The proportion of patients diagnosed with BE ≥3 cm per year declined during the study period, while the proportion of patients with BE ≥1 and<3 cm increased, and those with <1 cm remained stable. The mean age and the gender of patients diagnosed with BE ≥3 cm did not differ significantly by BE length or year of diagnosis. The mean length of newly diagnosed BE may be decreasing as a result of a decline in BE ≥3 cm. These observations cannot be explained by changes in age and gender.

Barrett's oesophagus length is established at the time of initial endoscopy and does not change over time: results from a large multicentre cohort

“…There are also limited data suggesting that BO length actually remains constant over time regardless of medical or surgical treatment 8 20–22. Resolving this uncertainty is key to addressing the increased risk of malignancy with BO length and may have an impact on surveillance recommendations and endoscopic therapy 6 7 9…”

Increasing prevalence of high-grade dysplasia and adenocarcinoma on index endoscopy in Barrett’s esophagus over the past 2 decades: data from a multicenter U.S. consortium

“…They also reported a decrease in the proportion of patients being diagnosed with BE >3 cm. 32 Kendall and Whiteman 28 found that the median length of long-segment BE decreased from 10 cm to 5 cm from 1990 to 1998 and 2002, and this was accompanied by an increase in the diagnosis of short-segment BE in that same time period.…”