LOW PREVALENCE OF BARRETT’S ESOPHAGUS IN A RISK AREA FOR ESOPHAGEAL CANCER IN SOUTH OF BRAZIL

ABSTRACT BACKGROUND: Barrett’s esophagus a complication of gastroesophageal reflux disease (GERD) is a precursor of esophageal adenocarcinoma. The incidence of esophageal adenocarcinoma has been increasing in most Western countries. Rio Grande do Sul (RS), the Southernmost state of Brazil has the highest rates of esophageal cancer with low prevalence of esophageal adenocarcinoma. OBJECTIVE: To investigate the prevalence of Barrett’s esophagus among patients underwent to upper gastrointestinal endoscopy in the last 5 years. METHODS: The records of patients underwent upper gastrointestinal endoscopy between 2011 and 2015 were analyzed. Demographic data, GERD symptoms, endoscopic findings, extension and histological diagnosis of columnar epithelia of the esophagus were recorded. Significance among the variables was accessed by chi-square test and Fisher’s exact test with 95% CI. RESULTS: A total of 5996 patients underwent to upper gastrointestinal endoscopy in the period were included. A total of 1769 (30%) patients with GERD symptoms or esophagitis and 107 (1.8%) with columnar lined esophagus were identified. Except for eight patients, the others with columnar lined esophagus had GERD symptoms or esophagitis. Barrett’s esophagus defined by the presence of intestinal metaplasia occurred in 47 patients; 20 (43%) with segments over 3 cm and 27 (57%) with segments shorter than 3 cm. The global prevalence of Barrett’s esophagus was 0.7% and in GERD patients 2.7%. The odds ratio for the occurrence of columnar lined esophagus in patients with GERD was 30 (95%CI=15.37-63.34). The odds ratio for the presence of intestinal metaplasia in long segments was 8 (95%CI=2.83-23.21). CONCLUSION: GERD patients had a risk 30-folds greater to present columnar lined esophagus than patients without GERD symptoms. Long segments of columnar lined esophagus, had a risk eight-folds higher to have Barrett’s esophagus than short segments. Barrett’s esophagus overall prevalence was 0.7%. In GERD patients, the prevalence was 2.7%. Long Barrett’s esophagus represented globally 0.3% and 1.1% in GERD patients.

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Risk Prediction of Barrett’s Esophagus in a Taiwanese Health Examination Center Based on Regression Models

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18105332 ◽

2021 ◽

Vol 18 (10) ◽

pp. 5332

Author(s):

Po-Hsiang Lin ◽

Jer-Guang Hsieh ◽

Hsien-Chung Yu ◽

Jyh-Horng Jeng ◽

Chiao-Lin Hsu ◽

...

Keyword(s):

Barrett’S Esophagus ◽

Risk Prediction ◽

Barrett's Esophagus ◽

Gastrointestinal Endoscopy ◽

Prediction Models ◽

Upper Gastrointestinal Endoscopy ◽

Health Examination ◽

Endoscopic Screening ◽

Risk Prediction Models ◽

Upper Gastrointestinal

Determining the target population for the screening of Barrett’s esophagus (BE), a precancerous condition of esophageal adenocarcinoma, remains a challenge in Asia. The aim of our study was to develop risk prediction models for BE using logistic regression (LR) and artificial neural network (ANN) methods. Their predictive performances were compared. We retrospectively analyzed 9646 adults aged ≥20 years undergoing upper gastrointestinal endoscopy at a health examinations center in Taiwan. Evaluated by using 10-fold cross-validation, both models exhibited good discriminative power, with comparable area under curve (AUC) for the LR and ANN models (Both AUC were 0.702). Our risk prediction models for BE were developed from individuals with or without clinical indications of upper gastrointestinal endoscopy. The models have the potential to serve as a practical tool for identifying high-risk individuals of BE among the general population for endoscopic screening.

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The burden of upper gastrointestinal endoscopy in patients with Barrett’s esophagus

Endoscopy ◽

10.1055/s-2006-944613 ◽

2006 ◽

Vol 38 (9) ◽

pp. 873-878 ◽

Cited By ~ 36

Author(s):

M. Kruijshaar ◽

M. Kerkhof ◽

P. Siersema ◽

E. Steyerberg ◽

M. Homs ◽

...

Keyword(s):

Barrett’S Esophagus ◽

Barrett's Esophagus ◽

Gastrointestinal Endoscopy ◽

Upper Gastrointestinal Endoscopy ◽

Upper Gastrointestinal

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Barrett’s Esophagus in Patients with Gastroesophageal Reflux Disease

Journal of Nepal Health Research Council ◽

10.3126/jnhrc.v16i2.20300 ◽

2018 ◽

Vol 16 (2) ◽

pp. 144-148 ◽

Cited By ~ 1

Author(s):

Khus Raj Dewan ◽

Bhanumati Saikia Patowary ◽

Subash Bhattarai ◽

Gaurav Shrestha

Keyword(s):

Barrett’S Esophagus ◽

Reflux Disease ◽

Barrett's Esophagus ◽

Gastrointestinal Endoscopy ◽

Asian Population ◽

Upper Gastrointestinal Endoscopy ◽

Suspected Case ◽

Squamous Cells ◽

Four Quadrant ◽

Upper Gastrointestinal

Background: Barrett’s esophagus a is metaplasia of normal squamous cells that line the lower part of the esophagus and carries a major risk for adenocarcinoma of esophagus. In Asian population, the prevalence of Barrett’s esophagus and adenocarcinoma are less common than in Western countries but has been increasing.Methods: This is a hospital based descriptive study comprising of 120 consecutive patients with symptoms of gastroesophagial reflux disease belonging to both sexes of any age group. The diagnosis of gastroesophagial reflux disease was based on the symptoms like heart burn and regurgitation. Upper gastrointestinal endoscopy was done in all the patients. Four quadrant biopsies were taken from the esophagogastric junction in suspected case of Barrett’s esophagus. The diagnosis of Barrett’s esophagus was confirmed histopathologically.Results: There were 44.2% males and 55.8% females, age ranging from 22 to 85 years mean being 44.33+13.37. Of them, gastroesophagial reflux disease was mild in 54.16%, moderate in 21.16% and severe in 16.66%. Upper Gastrointestinal endoscopy revealed non erosive gastroesophagial reflux disease in 50%, erosive in 45%, hiatal hernias in 5% and Barrett’s esophagus in 1.6%. Both patients with Barrett’s esophagus were elderly and had short segment (<3cm) involvement with no evidence of dysplasia or adenocarcinoma histopathologically.Conclusions: Endoscopic surveillance with detailed inspection and systematic biopsies is recommended for most patients with Barrett’s esophagus. Esophageal carcinoma if detected should be treated at the earliest.

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Low prevalence of Barrett's esophagus and esophageal adenocarcinoma over a 10-year period

Zeitschrift für Gastroenterologie ◽

10.1055/s-0033-1347488 ◽

2013 ◽

Vol 51 (05) ◽

Author(s):

J Láng ◽

B Bittera ◽

Z Varga ◽

A Koller ◽

B László ◽

...

Keyword(s):

Barrett’S Esophagus ◽

Esophageal Adenocarcinoma ◽

Barrett's Esophagus ◽

Low Prevalence

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Risk factors for Barrett’s esophagus in young adults who underwent upper gastrointestinal endoscopy in a health examination center

Therapeutic Advances in Gastroenterology ◽

10.1177/1756284819853115 ◽

2019 ◽

Vol 12 ◽

pp. 175628481985311 ◽

Cited By ~ 1

Author(s):

Pin-Chieh Wu ◽

Yan-Hua Chen ◽

Fu-Zong Wu ◽

Kung-Hung Lin ◽

Chiao-Lin Hsu ◽

...

Keyword(s):

Risk Factors ◽

Young Adults ◽

Potential Risk ◽

Gastrointestinal Endoscopy ◽

Significant Risk ◽

Upper Gastrointestinal Endoscopy ◽

Potential Risk Factors ◽

Male Sex ◽

Gerd Symptoms ◽

Upper Gastrointestinal

Background: Barrett’s esophagus (BE) is a premalignant condition with increased incidence worldwide both in old and young individuals. However, the role of certain potential risk factors remains unclear in young adults (< 50 years). We aimed to determine the risk factors of BE in young adults. Methods: A total of 4943 young adults who underwent upper gastrointestinal endoscopy at our health check-up center were enrolled. The diagnosis of BE was based on histological confirmation. We analyzed demographic factors, laboratory data, potential risk factors such as smoking, alcohol consumption, presence of gastroesophageal reflux disease (GERD) symptoms, and metabolic syndrome for the risk of BE by using binary logistic regression analysis. Results: The prevalence of BE was 1.8% (88/4943). Male sex, the presence of GERD symptoms, and smoking were three significant risk factors related to BE. Furthermore, participants who had smoked for 10 pack-years or more had increased risk of BE with dose-dependent phenomenon ( p trend < 0.001). The proportion of BE in male participants with both GERD symptoms and a smoking history of 10 pack-years or more was as high as 10.3% (16/155). Conclusions: Significant risk factors of BE in young adults are male sex, the presence of GERD symptoms, and smoking. The risk also increases with an increase in cumulative exposure to smoking.

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Appropriateness of Indications of Upper Gastrointestinal Endoscopy and its Association With Positive Finding

Journal of Nepal Medical Association ◽

10.31729/jnma.3121 ◽

2018 ◽

Vol 56 (209) ◽

pp. 504-509 ◽

Cited By ~ 1

Author(s):

Tanka Prasad Bohara ◽

Uttam Laudari ◽

Abishek Thapa ◽

Shail Rupakheti ◽

Mukund Raj Joshi

Keyword(s):

Odds Ratio ◽

Gastrointestinal Endoscopy ◽

Upper Gastrointestinal Endoscopy ◽

Positive Finding ◽

Significant Finding ◽

Cross Sectional ◽

Abdominal Symptoms ◽

Clinically Significant ◽

Upper Abdominal ◽

Upper Gastrointestinal

Introduction: Upper Gastrointestinal Endoscopy(UGIE) is a frequently advised investigation for upper abdominal symptoms. Studies have questioned the appropriateness of indications for UGIE and have shown that inappropriate indications range from 5% to 49%. The unnecessary UGIE expose patients to the risk. The number of UGIE is rising in our region and we assume so is the number of unnecessary UGIE. With an aim to evaluate the appropriateness of the indications of UGIE and compare its association with positive findings, we conducted a cross-sectional descriptive study. Methods: All patients undergoing diagnostic UGIE during the study period were included in the study. Appropriateness of indications for UGIE was defined as per American Society for Gastrointestinal Endoscopy(ASGE) criteria as “appropriate” and “inappropriate”. UGIE endoscopy findings were classified as “significant” and “insignificant” based on endoscopy findings. The extent of this association between the appropriateness of indications and UGIE findings was expressed as the odds ratio (OR) of finding a relevant diagnosis in patients with an ‘‘appropriate’’ indication compared with those with an ‘inappropriate’’ indication. Results: Seventy-nine patients were included in the study. Fifty- two (65.8 %) of the indications were considered appropriate as per ASGE guidelines. Thirty-three (63.5%) of the appropriate indications has clinically significant finding as compared to seven (25.9%) of inappropriate indication with an odds ratio of 4.962 (95%CI:1.773 – 13.890, p=0.002) which is statistically significant. Conclusions: Appropriate indications have significantly higher rates of clinically significant findings. Use of guidelines may decrease the number of unnecessary procedures.

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Barrett's Esophagus in an Area with an Exceptionally Low Prevalence of Helicobacter pylori Infection

ISRN Gastroenterology ◽

10.5402/2011/394734 ◽

2011 ◽

Vol 2011 ◽

pp. 1-4 ◽

Cited By ~ 6

Author(s):

Yeong Yeh Lee ◽

Sharifah Emilia Tuan Sharif ◽

Syed Hassan Syed Abd Aziz ◽

S. Mahendra Raj

Keyword(s):

Helicobacter Pylori ◽

Barrett’S Esophagus ◽

Reflux Esophagitis ◽

Barrett's Esophagus ◽

Urease Test ◽

Columnar Lined Esophagus ◽

H Pylori ◽

A Minor ◽

Low Prevalence ◽

Endoscopic Esophagitis

Objective. This study was undertaken to gain an insight into the relationship between Helicobacter pylori (H. pylori) infection, Barrett's esophagus and reflux esophagitis in an area of exceptionally low prevalence of H. pylori infection. Methods. A total of 1895 consecutive upper endoscopies performed between January 2005 and July 2007 were reviewed. 120 cases of columnar-lined esophagus and endoscopic esophagitis were evaluated. H. pylori infection was determined using the urease test and/or histology. Results. The rate of endoscopic esophagitis was 5.49% (80 Malays, 24 non-Malays) while histological reflux esophagitis was found in 3.75% (56 Malays, 15 non-Malays). Barrett's esophagus was present in 0.79% (11 Malays, 4 non-Malays). H. pylori infection was present in 8/120 or 6.67% subjects. Conclusion. The low rate of Barrett's esophagus in this population does not support the hypothesis that the absence of H. pylori infection is more than a minor risk factor for Barrett's esophagus.

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Detection rate of columnar-lining esophagus and adenocarcinoma among the residents of Leningrad region (according to esophagogastroduodenoscopy)

The Scientific Notes of the I P Pavlov St Petersburg State Medical University ◽

10.24884/1607-4181-2014-21-4-44-47 ◽

2014 ◽

Vol 21 (4) ◽

pp. 44-47

Author(s):

D. I. Vasilevskiy ◽

E. N. Kamalov ◽

S. U. Dvoretskiy ◽

S. S. Skurikhin ◽

D. S. Silantiev ◽

...

Keyword(s):

Gastrointestinal Tract ◽

Barrett’S Esophagus ◽

Esophageal Adenocarcinoma ◽

Barrett's Esophagus ◽

Detection Rate ◽

Developed Countries ◽

Upper Gastrointestinal Tract ◽

Leningrad Region ◽

Esophagus Cancer ◽

Upper Gastrointestinal

The incidence of esophageal adenocarcinoma among the population in economically developed countries has been increasing significantly for last three decades. Columnar-lining esophagus (Barrett's esophagus) is one of the proven factors of developing esophagus cancer. The prevalence of Barrett's esophagus and esophageal adenocarcinoma in Russia is not investigated enough. The analysis of the results of 34903 endoscopic examinations of the upper gastrointestinal tract in population of Leningrad region with symptoms of gastric dyspepsia during the period from 2007 to 2013 is presented in this article.

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