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Aliment Pharmacol Ther. 2014 Jun;39(11):1321-30. doi: 10.1111/apt.12759. Epub 2014 Apr 16.

The incidence of Barrett's oesophagus and oesophageal adenocarcinoma in the United Kingdom and The Netherlands is levelling off.

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  • 1Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands.

Abstract

BACKGROUND:

Barrett's oesophagus (BO) is a risk factor for oesophageal adenocarcinoma (OAC). Several studies report increasing incidences of BO with substantial variation.

AIM:

To determine age- and sex-stratified incidence rates (IR) of BO and OAC.

METHODS:

Cohort study using two primary care databases in the United Kingdom (UK) and the Netherlands (NL) (2000-2012). BO and OAC cases were identified using disease-specific READ codes (UK) and free-text search with manual validation (NL). Age- and sex-specific incidence rates (IRs) were calculated for both BO and OAC.

RESULTS:

From the study population of 6,885,420 subjects in the UK, we identified 12,312 incident BO and 40 (0.3%) subsequent incident OAC cases. There were 1383 incident BO, and subsequent 5 (0.4%) incident OAC cases among the 1,487,191 subjects in the NL. The IR of BO increased linearly with age: 15.6/100,000 PYs (UK) and 23.7/100,000 PYs (NL) for patients aged 40-44 years, increasing to 85.6/100,000 PYs (UK) and 87.0/100,000 PYs (NL) for 70-74 years. In both the UK and the NL, IR of BO was 2-4 times higher in males than females across all age groups. With respect to calendar time, the IR of BO increased by 35% (UK) and 41% (NL) from 2000 to 2003, after which IRs remained stable until 2012.

CONCLUSIONS:

The incidence rates of BO in the UK and the NL increased until 2003, but levelled off thereafter. Around 0.3% of patients with BO developed OAC at least 1 year after BO diagnosis. These findings may help tailor endoscopic surveillance strategies among patients with BO.

© 2014 John Wiley & Sons Ltd.

PMID:
24738722
[PubMed - indexed for MEDLINE]
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