Age and Sex Distribution of the Prevalence of Barrett's Esophagus Found in a Primary Referral Endoscopy Center

van Blankenstein, Mark; Looman, Caspar W.N.; Johnston, Belinda J.; Caygill, Christine P.J.
March 2005
American Journal of Gastroenterology;Mar2005, Vol. 100 Issue 3, p568
Academic Journal
BACKGROUND: Both the demographics underlying the sex ratio in the prevalence of Barrett's esophagus (BE) and the status of BE without intestinal metaplasia (IM) are unclear.AIMS: To establish the demographics of histologically proven BE, IM+ and IM−, over a 15-yr period from a primary referral, endoscopy unit.PATIENTS AND METHODS: For all BE patients aged 20–89 yr, identified between 1982 and 1996, IM+ or IM−, prevalences were calculated per 100 first endoscopies.RESULTS: A total of 492 cases of BE, 320 (248 IM+) in males, 175 (127 IM+) in females were identified in 21,899 first endoscopies (10,939 males, 10,960 females). Between ages 20 and 59 yr in males and 20–79 in females, IM+, IM− and all BE prevalences rose by±7.36% for each additional year of age (p= 0.92) with, however, a 20-yr age shift between the sexes, resulting in a male:female OR 4.15 95% CI 2.99–5.77. A declining rate of increase in over 59 males resulted in an overall male:female OR 2.14, 95% CI 1.77–2.58. Over the age of 79 yr, BE prevalences/100 first endoscopies fell from a maximum of 5.1 in males and 3.65 in females to 3.38 and 2.53, respectively.CONCLUSION: The 4:1 sex ratio and 20-yr age shift between males and females in the prevalence of BE, both IM+ and IM−, found in younger age groups, was the main cause of the overall BE 2:1 sex ratio. The very similar demographics of IM− and IM+ BE suggest they may be two consecutive stages in the same metaplastic process.(Am J Gastroenterol 2005;100:568–576)


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