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Trends in the epidemiology and outcome of barretts esophagus in southern europe



Trends in the epidemiology and outcome of barretts esophagus in southern europe



Digestive Disease Week Abstracts & Itinerary Planner : Abstract No W1289



INTRODUCTION: The proportion of Barrett's Esophagus (BE) that progresses to esophageal adenocarcinoma is critical for developing follow up strategies. There are no data of trends and outcomes of BE in Europe.AIMS: To identify changes in the incidence, prevalence and outcome of BE in a defined population in Spain.SUBJECTS & METHODS: Residents of Area III of Zaragoza, Spain, (250,000 inhabitants) with clinically diagnosed BE. The entire population of the area has open access to all health resources of the community and a single Endoscopy Unit has been operative for the last 28 years in this area. The records of this Unit were reviewed from January 1st,1976 to December 31st,2001. Follow up was performed until January 1st,2002.RESULTS: 491 cases of clinically diagnosed BE were identified over 26 years. The crude incidence increased 19-fold from 1.5/100,000 person years in the period 1976-1978 to 28.5/100,000 in 1999-2001 (15.7-fold for age and sex adjusted rates). In the same period of time upper GI endoscopic examinations increased 1.9-fold. However, the number of upper endoscopy examinations has not increased for the last 6 years, but the incidence of diagnosed BE has shown a 4-fold increase from 8/100,000 person years in 1997 to 32/100,000 in 2001. The crude prevalence of diagnosed BE increased from 12/100,000 person years in 1985 to 163/100,000 in 2001. The prevalence of short segment BE (<3cm) in 2001 was 99/100,000.A total of 40 cases of dysplasia and 24 of esophageal cancer were diagnosed. During follow up, which could be traced in 72% of patients without either dysplasia or carcinoma at diagnosis, 11 patients developed dysplasia and 10 carcinoma (6 adenocarcinomas, 2 schamous carcinomas, 1 undifferentiated and 1 unknown) for a rate of 1 case in 93 patient years for dysplasia and 1 case in 109 patient years for carcinoma.CONCLUSIONS: The Incidence and prevalence of clinically diagnosed Barrett's Esophagus have dramatically increased in our comunity, which is only partially explained by the increased use of endoscopy. Both adenocarcinoma and schamous carcinoma develops in patients with BE, but this compliacation is less frequent than previously reported.

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Accession: 035985584

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DOI: 10.1016/S0016-5085(03)83248-1



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