The global prevalence of Barrett’s esophagus: A systematic review of the published literature

Abstract

<jats:sec><jats:title>Background</jats:title><jats:p> Determining the prevalence of Barrett’s esophagus is important for defining screening strategies. We aimed to synthesize the available data, determine Barrett’s esophagus prevalence, and assess variability. </jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p> Three databases were searched. Subgroup, sensitivity, and meta-regression analyses were conducted and pooled prevalence was computed. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> Of 3510 studies, 103 were included. In the general population, we estimated a prevalence for endoscopic suspicion of Barrett’s esophagus of (a) any length with histologic confirmation of intestinal metaplasia as 0.96% (95% confidence interval: 0.85–1.07), (b) ≥1 cm of length with histologic confirmation of intestinal metaplasia as 0.96% (95% confidence interval: 0.75–1.18) and (c) for any length with histologic confirmation of columnar metaplasia as 3.89% (95% confidence interval: 2.25–5.54) . By excluding studies with high-risk of bias, the prevalence decreased to: (a) 0.70% (95% confidence interval: 0.61–0.79) and (b) 0.82% (95% confidence interval: 0.63–1.01). In gastroesophageal reflux disease patients, we estimated the prevalence with afore-mentioned criteria to be: (a) 7.21% (95% confidence interval: 5.61–8.81) (b) 6.72% (95% confidence interval: 3.61–9.83) and (c) 7.80% (95% confidence interval: 4.26–11.34). The Barrett’s esophagus prevalence was significantly influenced by time period, region, Barrett’s esophagus definition, Seattle protocol, and study design. There was a significant gradient East-West and North-South. There were minimal to no data available for several countries. Moreover, there was significant heterogeneity between studies. </jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p> There is a need to reassess the true prevalence of Barrett’s esophagus using the current guidelines in most regions. Having knowledge about the precise Barrett’s esophagus prevalence, diverse attitudes from educational to screening programs could be taken. </jats:p></jats:sec>

Value of age and alarm features for predicting upper gastrointestinal malignancy in patients with dyspepsia: an endoscopic database review of 4664 patients in Thailand

“…Open access GERD patients. 23 It is noteworthy that alarm features were not predictive of Barrett's oesophagus (data not shown).…”

“…In our analysis, Barrett’s oesophagus was found in only 0.5% of patients among all age groups of dyspeptic patients, similar to other reported endoscopic results in the general population but lower than in GERD patients. 23 It is noteworthy that alarm features were not predictive of Barrett’s oesophagus (data not shown).…”

The oesophageal microbiome and cancer: hope or hype?

“…Gastro-oesophageal reflux disease, caused by acid from the stomach entering the oesophagus, affects around 8% of the global population [6]. The inflammatory environment caused by the associated reflux oesophagitis is mutagenic, so that in ~7% of patients with reflux, the oesophageal epithelium undergoes metaplasia from squamous to columnar epithelium, leading to Barrett's oesophagus [7]. Barrett's oesophagus in turn is prone to malignant degeneration, with a risk of progression to adenocarcinoma of ~0.5% per patient, per year [8].…”

Endoscopic diagnosis and screening of Barrett's esophagus: Inconsistency of diagnostic criteria between Japan and Western countries

“…Accordingly, the reported prevalence of BE based on endoscopy findings in Japan varies widely, with results ranging from 15% to 85.9%, in contrast to the range in Western countries of 5% to 20%. 44 , 45 , 46 , 47 Adachi et al. reported that the prevalence of BE with a length of less than 1 cm was 56.2%, while that with a length of ≥ 1 cm was 26.2% when LCI was used to determine the area of BE, as the distal end of the palisade vessels was easily visualized.…”

“…Accordingly, the reported prevalence of BE based on endoscopy findings in Japan varies widely, with results ranging from 15% to 85.9%, in contrast to the range in Western countries of 5% to 20% 44–47 . Adachi et al.…”