The incidence of Barrett’s esophagus (BE) among relatively young people has surged in recent years, an analysis of a large health care database has found.
The study, of 50 million unique patient records between 2008 and 2013, showed that while the absolute incidence remains low among people younger than age 55 years, the share of cases in that group climbed sharply over the five-year period. Meanwhile, cases of BE among people over age 55 fell, suggesting a demographic shift in the disease with potentially important implications for screening, according to the researchers. As a precancerous condition, BE may be more dangerous in younger patients because of the longer time for the abnormal cells to progress to malignancy.
“The increase in the rate of BE was particularly high in the age group of 25 to 34 years,” said Sasan Sakiani, MD, of the Division of Gastroenterology at MetroHealth Medical Center, in Cleveland, and a study co-author.
Ronnie Fass, MD, director of the Division of Gastroenterology and Hepatology at MetroHealth, who helped conduct the study, said more research is needed to identify the underlying basis for the trend.
“The impetus behind the study was the growing number of younger patients with GERD [gastroesophageal reflux disease]-related symptoms who were diagnosed with Barrett’s esophagus in our clinic,” Dr. Fass said. “It was important for us to further assess this trend because of the important impact it will likely have on our current guidelines for BE screening.”
Dr. Sakiani’s group presented the findings at Digestive Disease Week 2015 (abstract SA1881). The researchers analyzed the Explorys database, which includes data from 317,000 providers admitting patients to 360 hospitals in the United States. The database was initially surveyed by the International Classification of Diseases, 9th edition code for GERD, symptoms of heartburn and other risk factors for BE. The researchers conducted additional analyses to find patients who underwent endoscopy and received a diagnosis of BE between 2008 and 2013, to establish an annual incidence by patient age, sex and race.
“There was a steady increase in both the number of endoscopic procedures performed each year and the incidence of BE,” Dr. Sakiani said. By 2013, the number of endoscopies had risen to 201,140 from 79,040 in 2008, while the incidence of BE increased from 1,970 to 4,269 over that period.
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Bosworth, Ted. “Barrett’s Esophagus Appears To Be Spiking in Younger Patients.” Gastroenterology & Endoscopy News – Web. 17 July 2015.