Prevalence and risk factors for Barrett’s esophagus in Taiwan

Abstract

BACKGROUND Barrett’s esophagus (BE) is a pre-malignant condition associated with the development of esophageal adenocarcinoma. The prevalence of BE in the general populations of Asian countries ranges from 0.06% to 1%. However, with lifestyle changes in Asian countries and adoption of western customs, the prevalence of BE might have increased. AIM To determine the current prevalence of BE in Taiwan, and to investigate risk factors predicting the presence of BE. METHODS This retrospective study was conducted at the Health Evaluation Center of Kaohsiung Veterans General Hospital in Taiwan. Between January 2015 and December 2015, 3385 subjects undergoing routine esophagogastroduodenoscopy examinations as part of a health check-up at the Health Evaluation Center were included. Patient characteristics and endoscopic findings were carefully reviewed. Lesions with endoscopic findings consistent with BE awaiting histological evaluation were judged as endoscopically suspected esophageal metaplasia (ESEM). BE was defined based on extension of the columnar epithelium ≥ 1 cm above the gastroesophageal junction and was confirmed based on the presence of specialized intestinal metaplasia (IM) in the metaplastic esophageal epithelium. Clinical factors of subjects with BE and subjects without BE were compared, and the risk factors predicting BE were analyzed. RESULTS A total of 3385 subjects (mean age, 51.29 ± 11.42 years; 57.1% male) were included in the study, and 89 among them were confirmed to have IM and presence of goblet cells via biopsy examination. The majority of these individuals were classified as short segment BE ( n = 85). The overall prevalence of BE was 2.6%. Multivariate analysis disclosed that old age [odds ratio (OR) = 1.033; 95% confidence interval (CI): 1.012-1.055; P = 0.002], male gender (OR = 2.106; 95%CI: 1.145-3.872; P = 0.017), ingestion of tea (OR = 1.695; 95%CI: 1.043-2.754; P = 0.033), and presence of hiatal hernia (OR = 3.037; 95%CI: 1.765-5.225; P < 0.001) were significant risk factors predicting BE. The independent risk factor for the presence of IM in ESEM lesions was old age alone (OR = 1.029; 95%CI: 1.006-1.053; P = 0.014). CONCLUSION Current prevalence of BE among the general population in Taiwan is 2.6%. Old age, male gender, ingestion of tea and hiatal hernia are significant risk factors for BE.

Epidemiological Review of Gastroesophageal Junction Adenocarcinoma in Asian Countries

“…It is obvious that the current increase in GERD cases in Western countries has contributed to the increased prevalence of esophageal adenocarcinoma and GEJ adenocarcinoma. In recent years, Asian countries have reported an increased prevalence of GERD [11], which is similar to the trend in Western countries. However, according to a large epidemiological study of Asian countries, the incidence of esophageal adenocarcinoma and GEJ adenocarcinoma is not as high as that in Western countries (Table 1) [25-31].…”

“…Several risk factors, such as gastroesophageal reflux disease (GERD), obesity, smoking, and low Helicobacter pylori ( H. pylori ) infection rates, have been associated with an increase in the prevalence of GEJ adenocarcinoma [2-5]. Nowadays, there have been several large-scale studies on risk factors for GEJ adenocarcinomas from Asian countries [6-11]. In 1999, Blaser proposed that the prevalence of reflux esophagitis and GEJ adenocarcinomas would increase in the future due to changes in the H. pylori infection rate [12].…”

Risk factors associated with Barrett's esophagus in hospitalized patients

“…Según las características demográficas, para diversos autores el sexo masculino es un factor de riesgo de Esófago de Barrett (4,5,6,7,8,9) . Aunque Matheus Degiovani et al, dice que el sexo femenino es un factor de riesgo de Esófago de Barret (10) .…”

“…Aunque Matheus Degiovani et al, dice que el sexo femenino es un factor de riesgo de Esófago de Barret (10) . Según diversos autores la edad incrementada es un factor de riesgo (4,6,7,9,10,11,12,13,14) . Aunque Emery C Lin et al, encontró que el OR incrementa desde los 40 años constantemente hasta los 69 años donde su OR es 1.68.5…”

Assessment of the Relationship Between Gastric-Acid Suppressants and the Risk of Esophageal Adenocarcinoma: A Systematic Review and Meta-Analysis

“…Barrett's metaplasia is attributed to a genetic predisposition, gender, gastroesophageal reflux disease, smoking, alcohol consumption, high body mass index, and a poor diet lacking fruit and vegetables. 4 In previous studies, antisecretory drugs, including proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2RAs), were assumed to induce anticancer properties and reduce EAC development.…”