Skip to main content

Advertisement

SpringerLink
Log in

Increased Barrett's Esophagus for the Decade Between 1991 and 2000 at a Single University Medical Center

  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Barrett's esophagus is being diagnosed increasingly in the United States. The aim of this study was to determine whether the increased diagnosis of Barrett's esophagus is due to endoscopic reporting and/or a truly increasing rate. This retrospective study reviewed 18,183 endoscopy reports at Temple University Hospital from January 1991 through December 2000. Annual rates of new cases of endoscopically suspected Barrett's esophagus were determined. Biopsy results were reviewed for the diagnosis of Barrett's esophagus (i.e., specialized intestinal metaplasia). Rates of Barrett's esophagus increased from 3.22 to 8.28 per 100 endoscopies (257%; P < 0.01) on endoscopy and from 0.67 to 2.76 per 100 endoscopies (412%; P < 0.01) on histology from 1991 to 2000. Twenty-four and seven-tenths percent (252/1020) of patients suspected at endoscopy to have Barrett's esophagus were confirmed by histology. This study demonstrates an increasing rate of new cases of suspected Barrett's esophagus on endoscopy and confirmed Barrett's esophagus on histology over the last decade. The endoscopic impression of Barrett's esophagus was about four times higher than the confirmed diagnosis of Barrett's esophagus (intestinal metaplasia) on histology.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Barrett NR: The lower esophagus lined by columnar epithelium. Surgery 41:881–94, 1957

    PubMed  Google Scholar 

  2. Spechler SJ, Goyal RK: The columnar-lined esophagus, intestinal metaplasia and Norman Barrett. Gastroenterology 110:614–621, 1996

    Article  PubMed  Google Scholar 

  3. Sampliner RE: The Practice Parameters Committee of the American College of Gastroenterology practice guidelines on the diagnosis, surveillance and therapy of Barrett's esophagus. Am J Gastroenterol 93:1028–1032, 1998

    Article  PubMed  Google Scholar 

  4. Goyal RK, Hamilton FA: Columnar-lined (Barrett's) esophagus: Highlights of the NIDDK/VHA conference. Clinician 17:1–30, 1999

    Google Scholar 

  5. Stein HJ, Siewert JR: Barrett's esophagus: pathogenesis, epidemiology, functional abnormalities, malignant degeneration, and surgical management. Dysphagia 8:276–288, 1993

    Article  PubMed  Google Scholar 

  6. Cameron AJ: Epidemiology of columnar-lined esophagus and adenocarcinoma. Gastroenterol Clin North Am 26:487–494, 1997

    Article  PubMed  Google Scholar 

  7. Rex DK, Cummings OW, Shaw M, et al.: Screening for Barrett's esophagus in colonoscopy patients with and without heartburn. Gastroenterology 125:1670–1677, 2003

    Article  PubMed  Google Scholar 

  8. Spechler ST, Goyal RK: Barrett's esophagus. N Engl J Med 315:362–371, 1986

    PubMed  Google Scholar 

  9. Iascone C, DeMeester TR, Little AG, Skinner DB: Barrett's esophagus: functional assessment, proposed pathogenesis and surgical therapy. Arch Surg 118:543–549, 1983

    PubMed  Google Scholar 

  10. Lieberman DA, Oekla M, Helfand M, GORGE consortium: Risk factors for Barrett's esophagus in community-based practice. Am J Gastroenterol 92:1293–1297, 1997

    PubMed  Google Scholar 

  11. Lagergren J, Bergstrom R, Lingren A, Nyren O: Symptomatic gastroesophageal reflux as a risk factor for esophageal adenocarcinoma. N Engl J Med 340:825–831, 1999

    Article  PubMed  Google Scholar 

  12. Cameron AJ, Ott BJ, Payne WJ: Barrett's oesophagus: Incidence of adenocarcinoma during long-term follow-up. Gut 24:A1007–A1008, 1983

    Google Scholar 

  13. Yang PC, Davis S: Incidence of cancer of the esophagus in the United States by histologic type. Cancer 612–617, 1988

  14. Pera M, Cameron AJ, Trostek VF, et al.: Increasing incidence of adenocarcinoma of the esophagus and esophagogastric junction. Gastroenterology 104:510–513, 1993

    PubMed  Google Scholar 

  15. Devesa SS, Blot WJ, Fraumeni JF: Changing patterns in the incidence of esophageal and gastric carcinoma in the United States. Cancer 83:2049–2053, 1998

    Article  PubMed  Google Scholar 

  16. O'Conner JB, Falk GW, Richter JE: The incidence of adenocarcinoma and dysplasia in Barrett's esophagus. Am J Gastroenterol 8:2037–2042, 1999

    Google Scholar 

  17. Pera M: Epidemiology of esophageal cancer, especially adenocarcinoma of the esophagus and esophagogastric junction. Recent Res Cancer Res 155:1–14, 2000

    Google Scholar 

  18. Hirota WK, Longhney TM, Lazas DJ, Maydonovitch CL, Rholl V, Wong RRH: Specialized intestinal metaplasia, dysplasia and cancer of the esophagus and esophagogastric junction: Prevalence and clinical data. Gastroenterology116:277–285, 1999

    PubMed  Google Scholar 

  19. Bytzer P, Christensen PB, Damkier P, Vinding K, Seersholm N: Adenocarcinoma of the esophagus and Barrett's esophagus: a population based study. Am J Gastroenterol 94:86–91, 1999

    Article  PubMed  Google Scholar 

  20. Clark GW, Smyrk TC, Budiles P, Hoeft SF, Peters JH, Kiyabu M, Hinder RA, Bremner CG, DeMeester TR: Is Barrett's metaplasia the source of adenocarcinoma of the cardia? Arch Surg129:609–614, 1994

    PubMed  Google Scholar 

  21. Cameron AJ, Lomboy CT, Pera M, Carpenter HA: Adenocarcinoma of the esophagogastric junction in Barrett's esophagus. Gastroenterology 109:1541–1546, 1995

    Article  PubMed  Google Scholar 

  22. Spechler SJ, Zeroogian JM, Antonidi DA, et al.: Prevalence of metaplasia at the gastroesophageal junction. Lancet 334:1533–1536, 1994

    Article  Google Scholar 

  23. Dias Periera A, Suspiro A, Chaves P, Saraiva A, Gloria L, Mendes de Almeida JC, Leitao CN, Soares J, Mira FC: Short segment of Barrett's epithelium and intestinal metaplasia in normal appearing esophagogastric junction: The same or two different.entities? Gut 42:659–662, 1998

    PubMed  Google Scholar 

  24. Johnston MH, Hammond AS, Laskin W, Michael Jones D: The prevalence and clinical characteristics of short segments of specialized intestinal metaplasia in the distal esophagus on routine endoscopy. Am J Gastroenterol 91:1507–1511, 1996

    PubMed  Google Scholar 

  25. Nandurkar S, Talley NJ: Barrett's esophagus: the long and the short of it. Am J Gastroenterol 94:30–40, 1999

    Article  PubMed  Google Scholar 

  26. Nandurkar S, Talley NJ, Martin CJ, Ng TH, Adams S: Short segment Barrett's esophagus: prevalence, diagnosis and associations. Gut 40:710–715, 1997

    PubMed  Google Scholar 

  27. Trudgill NJ, Suvarna SK, Lapur KC, Riley SA: Intestinal metaplasia at the squamo-columnar junction in patients attending for diagnostic gastroscopy Gut 41:585–589, 1997

    PubMed  Google Scholar 

  28. Sharma P: Recent advances in Barrett's esophagus: Short segment Barrett's esophagus and cardia intestinal metaplasia. Semin Gastrointest Dis 10:93–102, 1999

    PubMed  Google Scholar 

  29. Spechler S: The role of gastric carditis in metaplasia and neoplasia at the gastroesophageal junction. Gastroenterology 117:218–228, 1998

    Google Scholar 

  30. Spechler S: Adenocarcinoma of the gastroesophageal junction. Clin Perspect Gastroenterol 3/4:93–99, 1999

    Google Scholar 

  31. Avidian B, Sonnenberg A, Schnell TG, Chejfel G, Metz A, Sontag SJ: Hiatal hernia size, Barrett's length and severity of acid reflux are all risk factors of esophageal adenocarcinoma. Am J Gastroenterol 97:1930–1936, 2002

    Article  PubMed  Google Scholar 

  32. Sharma P, Morales T, Bhattacharyya A, Garewal H, Sampliner R: Dysplasia in short segment Barrett's esophagus—a prospective 3-year follow-up. Am J Gastroenterol 92:2012–2016, 1997

    PubMed  Google Scholar 

  33. Daniel WW: Biostatistics: A foundation for analysis in the health sciences. New York, John Wiley & Sons, 1999

    Google Scholar 

  34. Prach AT, MacDonald TA, Hopwood DA, Johnston DA: Increasing incidence of Barrett's oesophagus: Education, enthusiasm, or epidemiology? Lancet 350:993, 1997

    Article  Google Scholar 

  35. Conio M, Cameron AJ, Romero Y, Branch CD, Schuleck CP, Burgast LJ, Zinsmeister AR, Melton IJ III, Lake GR III: Secular trends in the epidemiology and outcome of Barrett's esophagus in Olmsted County, Minnesota. Gut 48:304–309, 2001

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Gastroenterology Section and Department of Pathology, Temple University School of Medicine, 3401 North Broad Street, Philadelphia, Pennsylvania, 19140, USA

    Shayan Irani MD, Henry P. Parkman MD, Rebecca Thomas MD, Benjamin Krevsky MD, Robert S. Fisher MD & Peter Axelrod MD

Authors
  1. Shayan Irani MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Henry P. Parkman MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rebecca Thomas MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Benjamin Krevsky MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Robert S. Fisher MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Peter Axelrod MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Robert S. Fisher MD.

Additional information

This study was reported in abstract form at the American College of Gastroenterology in October 2003 and appeared in the American Journal of Gastroenterology 98 (Suppl):S16–S17, 2003.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Irani, S., Parkman, H.P., Thomas, R. et al. Increased Barrett's Esophagus for the Decade Between 1991 and 2000 at a Single University Medical Center. Dig Dis Sci 50, 2141–2146 (2005). https://doi.org/10.1007/s10620-005-3021-y

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-005-3021-y

Keywords

Search

Navigation