Introduction Barrett’s oesophagus (BO) is a metaplastic change of the lining of the oesophagus; the normal squamous epithelium is replaced by specialised columnar epithelium. BO is a risk factor for oesophageal adenocarcinoma, which is increasing in incidence in developed countries¹. Risk factors for BO are age, being white Caucasian and male gender². To our knowledge, no differences have previously been found between the mean length of Barrett’s segment or the mean age of BO patients in differing ethnic groups

Methods We performed a retrospective analysis of electronic patient records at St George’s Hospital, which serves a large ethnically diverse population. Patients with a diagnosis of BO were identified from gastroscopy records dating from 2009 to 2012. Demographic information was collected for every patient. Patients of Indian sub-continent Asian (ISA) origin were identified using surname as previously described3. We looked at length of Barrett’s, gender and age in ISAs, compared to other ethnic groups

Results 499 procedures were identified where the diagnosis was BO. Multiple reports for individual patients were excluded, identifying 378 patients with an endoscopic diagnosis of BO. Mean age of the sample was 67 years (SD 14.4). 11% of the sample were of ISA origin, 89% were of non-ISA origin. No significant difference was found in the mean length of the Barrett’s segment between males and females. However, male patients with BO were younger than females (65.5 years vs. 70.2 years; p = 0.003). No significant difference was found in the mean Barrett’s length or mean age between ISAs and non-ISAs. Patients of ISA origin were not found to have any significant difference between mean length of Barrett’s segment or mean age. Patients of non-ISA origin had no significant difference was in mean Barrett’s length between males and females, but there was a statistically significant difference between mean age of male Barrett’s patients (65.1 y) and female Barrett’s patients (70.7 y: p = 0.01) in this group

Conclusion In our ethnically diverse population, male patients with Barrett’s oesophagus are younger than female patients. Furthermore, this difference occurs only in patients of non-Indian sub-continent origin. This implies that there may be an environmental factor in the UK which confers an accelerated progression of Barrett’s oesophagus in male patients. Further study in this area is warranted

Disclosure of Interest None Declared.

References

1. Shaheen & Ransohoff. Gastroesophageal reflux, Barrett oesophagus, and esophageal cancer: scientific review. JAMA 2002: 287: 1972–1981

2. Ford et al. Ethnicity, Gender, and Socioeconomic Status as Risk Factors for Esophagitis and Barrett’s Esophagus. American Journal of Epidemiology 2005: 162: 454–460

3. Kang et al. Diverticular disease of the colon: ethnic differences in frequency. Aliment.Pharmacol.Ther. 2004: 19: 765–769