Race, ethnicity, sex and temporal differences in Barrett’s oesophagus diagnosis: a large community-based study, 1994–2006
- 1Division of Research, Kaiser Permanente, Oakland, California, USA
- 2Department of Medicine University of California, San Francisco, California, USA
- 3School of Public Health University of California, Berkeley, California, USA
- 4Kaiser Permanente, Oakland Medical Center, Oakland, California, USA
- Dr D A Corley, Division of Research, Kaiser Permanente, 2000 Broadway, Oakland, CA 94612, USA; Douglas.Corley{at}kp.org
- Revised 15 October 2008
- Accepted 18 October 2008
- Published Online First 31 October 2008
Abstract
Objective: To evaluate the demographics and incidence of Barrett’s oesophagus diagnosis using community-based data.
Design: Observational study.
Setting: Kaiser Permanente, Northern California healthcare membership, 1994–2006.
Patients: Members with an electronic diagnosis of Barrett’s oesophagus.
Main outcome measures: Incidence and prevalence of a new Barrett’s oesophagus diagnosis by race, sex, age and calendar year.
Results: 4205 persons met the study definition for a diagnosis of Barrett’s oesophagus. The annual incidence in 2006 was highest among non-Hispanic whites (39/100 000 race-specific member-years, 95% confidence interval (95% CI) 35 to 43), with lower rates among Hispanics (22/100 000, 95% CI 16 to 29), Asians (16/100 000, 95% CI 11 to 22), and blacks (6/100 000, 95% CI 2 to 12). The annual incidence was higher among men than women (31 vs 17/100 000, respectively, year 2006; p<0.01). The incidence increased with age from 2 per 100 000 for persons aged 21–30 years, to a peak of 31 per 100 000 member-years for persons aged 61–70 years (year 2006). There was no increase in the incidence of new diagnoses until the last two observation years, which coincided with changes in data collection methods and may be due to bias. The overall prevalence among active members increased almost linearly to 131/100 000 member-years by 2006.
Conclusions: The demographic distributions of Barrett’s oesophagus differ markedly by race, age and sex and were comparable to those for oesophageal adenocarcinoma. Thus, demographic disparities in oesophageal adenocarcinoma risk may arise partly from the risk of having Barrett’s oesophagus, rather than from differing risks of progression from Barrett’s oesophagus to cancer. There has been an almost linear increase in the prevalence of diagnosed disease.
Footnotes
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Funding: United States National Institutes of Health RO1 DK63616, the Kaiser Permanente Research Project on Genes, Environment and Health, and a Kaiser Permanente Community Benefits Grant. Role of sponsor: the sponsors reviewed the study design, but had no role in the collection, analysis or interpretation of the data, in the writing of the report, or in the decision to submit the report for publication.
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Competing interests: None.
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Ethics approval: The study and analyses were approved by the Kaiser Permanente Institutional Review Board in August 2002
