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Original research
Global prevalence of Barrett’s oesophagus and oesophageal cancer in individuals with gastro-oesophageal reflux: a systematic review and meta-analysis
  1. Leonardo Henry Eusebi1,
  2. Giovanna Grazia Cirota1,
  3. Rocco Maurizio Zagari1,
  4. Alexander Charles Ford2
  1. 1 Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
  2. 2 Leeds Gastroenterology Institute, St James's University Hospital, Leeds, West Yorkshire, UK
  1. Correspondence to Professor Alexander Charles Ford, Leeds Gastroenterology Institute, St. James's University Hospital, Leeds LS9 7TF, UK; alexf12399{at}


Objectives Chronic gastro-oesophageal reflux might lead to the development of Barrett’s oesophagus (BO) or even oesophageal adenocarcinoma. There has been no definitive systematic review and meta-analysis of data to estimate global prevalence of BO or oesophageal adenocarcinoma in individuals with gastro-oesophageal reflux.

Design We searched MEDLINE, Embase and Embase Classic to identify cross-sectional surveys that reported prevalence of BO or oesophageal adenocarcinoma in adults with gastro-oesophageal reflux. We extracted prevalence for all studies, both for endoscopically suspected and histologically confirmed cases. We calculated pooled prevalence according to study location, symptom frequency and sex, as well as ORs with 95% CIs.

Results Of the 4963 citations evaluated, 44 reported prevalence of endoscopically suspected and/or histologically confirmed BO. Prevalence of BO among individuals with gastro-oesophageal reflux varied according to different geographical regions ranging from 3% to 14% for histologically confirmed BO with a pooled prevalence of 7.2% (95% CI 5.4% to 9.3%), whereas pooled prevalence for endoscopically suspected BO was 12.0% (95% CI 5.5% to 20.3%). There was heterogeneity in many of our analyses. Prevalence of BO was significantly higher in men, both for endoscopically suspected (OR=2.1; 95% CI 1.6 to 2.8) and histologically confirmed BO (OR=2.3; 95% CI 1.7 to 3.2). Dysplasia was present in 13.9% (95% CI 8.9% to 19.8%) of cases of histologically confirmed BO, 80.7% of which was low-grade.

Conclusion The prevalence of Barrett’s oesophagus among individuals with gastro-oesophageal reflux varied strikingly among countries, broadly resembling the geographical distribution of gastro-oesophageal reflux itself. Prevalence of BO was significantly higher in men.

  • barrett's oesophagus
  • gastroesophageal reflux disease

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  • Contributors LHE, GGC, RMZ and ACF conceived and drafted the study. LHE and GGC collected all data. ACF and LHE analysed and interpreted the data. LHE and ACF drafted the manuscript. All authors commented on drafts of the paper. All authors have approved the final draft of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Ethics approval Ethical approval was not required as the study is a systematic review and meta-analysis of previously published data.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.

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