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Increasing incidence of Barrett’s oesophagus in the general population
  1. E M van Soest1,
  2. J P Dieleman3,
  3. P D Siersema2,
  4. M C J M Sturkenboom4,
  5. E J Kuipers2
  1. 1Department of Gastroenterology and Hepatology, and Department of Medical Informatics, Erasmus University Medical Centre, Rotterdam, the Netherlands
  2. 2Department of Gastroenterology and Hepatology, Erasmus University Medical Centre, Rotterdam, the Netherlands
  3. 3Department of Medical Informatics, Erasmus University Medical Centre, Rotterdam, the Netherlands
  4. 4Department of Epidemiology and Biostatistics, and Department of Medical Informatics, Erasmus University Medical Centre, Rotterdam, the Netherlands
  1. Correspondence to:
    MrsE M van Soest
    Department of Gastroenterology and Hepatology, Erasmus University Medical Centre, Postbus 2040, 3000 CA Rotterdam, the Netherlands; e.vansoesterasmusmc.nl

Abstract

Background: Barrett’s oesophagus (BO) predisposes to oesophageal adenocarcinoma. Epidemiological data suggest that the incidence of BO is rising but it is unclear whether this reflects a true rise in incidence of BO or an increase in detection secondary to more upper gastrointestinal endoscopies performed. This study aimed to examine the changes in BO incidence relative to the number of upper gastrointestinal endoscopies performed in the general population.

Methods: We conducted a cohort study using the Integrated Primary Care Information database. This general practice research database contains the complete and longitudinal electronic medical records of more than 500 000 persons.

Results: In total, 260 incident cases of BO were identified during the study period. The incidence of BO increased from 14.3/100 000 person years in 1997 (95% confidence interval (CI) 8.6–22.4) to 23.1/100 000 person years (95% CI 17.2–30.6) in 2002 (r2 = 0.87). The number of upper gastrointestinal endoscopies decreased from 7.2/1000 person years (95% CI 6.7–7.7) to 5.7/1000 person years (95% CI 5.4–6.1) over the same time period. This resulted in an overall increase in detected BO per 1000 endoscopies from 19.8 (95% CI 12.0–31.0) in 1997 to 40.5 (95% CI 30.0–53.5) in 2002 (r2 = 0.93). The incidence of adenocarcinoma increased from 1.7/100 000 person years (95% CI 0.3–5.4) in 1997 to 6.0/100 000 person years (95% CI 3.3–10.2) in 2002 (r2 = 0.87).

Conclusion: The incidence of diagnosed BO is increasing, independent of the number of upper gastrointestinal endoscopies that are being performed. This increase in BO incidence will likely result in a further increase in the incidence of oesophageal adenocarcinomas in the near future.

  • BO, Barrett’s oesophagus
  • AC, adenocarcinoma
  • IPCI, Integrated Primary Care Information
  • ICPC, International Classification for Primary Care
  • Barrett’s oesophagus
  • adenocarcinoma
  • incidence
  • primary care

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Footnotes

  • Published online first 27 April 2005

  • Conflict of interest: None declared.