OBJECTIVES: Barrett's esophagus (BE) is traditionally thought of as a disease of middle-aged Caucasian men. Little is known about BE in younger patients. We sought to assess the effect of age on features of BE including the prevalence and incidence of dysplasia and carcinoma. METHODS: All patients enrolled into the Cleveland Clinic BE registry from 1979 to 2002 were studied. Age, ethnicity, number of endoscopies, hiatal hernia size, length of Barrett's segment, prevalence and incidence of dysplasia, and cancer were compared between patients > or = 50 yr old and < 50 yr old. RESULTS: There were 837 patients in the registry (638 > or = 50 yr, 199 < 50 yr). Hiatal hernia size was larger in patients > or = 50 yr than in those < 50 yr (median 4.0 cm, interquartile range 2.0-5.0 cm vs 3.0, 2.0-4.0 cm; p < 0.01). Otherwise, there were no significant differences among other features in the patient population. There were 225 patients with dysplasia or cancer (195 > or = 50 yr and 30 < 50 yr; p < 0.01). Of this group, 176 were prevalent cases (159 > or = 50 yr and 17 < 50 yr) and 49 were incident cases (36 > or = 50 yr and 13 < 50 yr). The odds of those > or = 50 yr being a prevalent case of high-grade dysplasia or cancer was five times the odds of those < 50 yr (p < 0.01). The incidence of dysplasia or cancer was similar in both age groups. CONCLUSIONS: Our study supports emerging data that approximately 25% of BE patients are less than 50 yr of age. While older patients had a higher prevalence of dysplasia or adenocarcinoma, the incidence of dysplasia and adenocarcinoma is similar in both age groups. Future screening strategies for BE should recognize these important findings.
OBJECTIVES: Barrett's esophagus (BE) is traditionally thought of as a disease of middle-aged Caucasian men. Little is known about BE in younger patients. We sought to assess the effect of age on features of BE including the prevalence and incidence of dysplasia and carcinoma. METHODS: All patients enrolled into the Cleveland Clinic BE registry from 1979 to 2002 were studied. Age, ethnicity, number of endoscopies, hiatal hernia size, length of Barrett's segment, prevalence and incidence of dysplasia, and cancer were compared between patients > or = 50 yr old and < 50 yr old. RESULTS: There were 837 patients in the registry (638 > or = 50 yr, 199 < 50 yr). Hiatal hernia size was larger in patients > or = 50 yr than in those < 50 yr (median 4.0 cm, interquartile range 2.0-5.0 cm vs 3.0, 2.0-4.0 cm; p < 0.01). Otherwise, there were no significant differences among other features in the patient population. There were 225 patients with dysplasia or cancer (195 > or = 50 yr and 30 < 50 yr; p < 0.01). Of this group, 176 were prevalent cases (159 > or = 50 yr and 17 < 50 yr) and 49 were incident cases (36 > or = 50 yr and 13 < 50 yr). The odds of those > or = 50 yr being a prevalent case of high-grade dysplasia or cancer was five times the odds of those < 50 yr (p < 0.01). The incidence of dysplasia or cancer was similar in both age groups. CONCLUSIONS: Our study supports emerging data that approximately 25% of BE patients are less than 50 yr of age. While older patients had a higher prevalence of dysplasia or adenocarcinoma, the incidence of dysplasia and adenocarcinoma is similar in both age groups. Future screening strategies for BE should recognize these important findings.
Authors: John M Inadomi; Ma Somsouk; Ryan D Madanick; Jennifer P Thomas; Nicholas J Shaheen Journal: Gastroenterology Date: 2009-03-06 Impact factor: 22.682
Authors: Claudia Ringhofer; Johannes Lenglinger; Barbara Izay; Katharina Kolarik; Johannes Zacherl; Margit Eisler; Fritz Wrba; Parakrama T Chandrasoma; Enrico P Cosentini; Gerhard Prager; Martin Riegler Journal: Wien Klin Wochenschr Date: 2008 Impact factor: 1.704