Prevalence of precancerous and other metaplasia in the distal oesophagus and gastro-oesophageal junction.
OBJECTIVE
The epidemiology of Barrett's oesophagus (BO) is characterized by divergent results. The aim of this study was to estimate the prevalence of BO and intestinal metaplasia (IM) at the gastro-oesophageal junction (GOJ) in a population-based series of patients referred for first-time gastroscopy.


METHODS
Consecutive patients who underwent endoscopy for the first time at endoscopy units exclusively serving defined catchment areas were invited to take part in the study. Biopsies were taken immediately below the GOJ and from the distal oesophagus, and clinical data were recorded.


RESULTS
A total of 769 patients (mean age 53 years, 43% M) were examined. Overall IM prevalence was 14%. BO was noted in 4%. Overall, the prevalence of IM increased by 8% (95% CI 6-10%) per year of age. BO patients were predominately women (69%). Presence of cardia-type mucosa in the cardia increased with age from 25% among the youngest to 59% among the oldest patients. Pancreatic acinar metaplasia (PAM) was found in 18%.


CONCLUSIONS
While BO is not common among Swedish gastroscopy patients, IM and PAM are found in every 7th and 6th patient, respectively. Age-dependent increments in prevalence suggest that not only BO and IM, but also cardia-type mucosa are acquired and/or progressive lesions.
Johansson
Johan
J
Department of Surgery, Kalmar County Hospital, Kalmar, Sweden. Johan.Johansson @meb.ki.se
Håkansson
Hans-Olof
HO
Mellblom
Lennart
L
Kempas
Antti
A
Johansson
Karl-Erik
KE
Granath
Fredrik
F
Nyrén
Olof
O
D000293:Adolescent; D000328:Adult; D000368:Aged; D001471:Barrett Esophagus / Q000453:epidemiology / Q000473:pathology*; D001706:Biopsy; D016099:Endoscopy, Gastrointestinal; D004943:Esophagogastric Junction / Q000473:pathology*; D004947:Esophagus / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D005753:Gastric Mucosa / Q000473:pathology; D006801:Humans; D008297:Male; D008679:Metaplasia / Q000453:epidemiology / Q000473:pathology; D008875:Middle Aged; D011230:Precancerous Conditions / Q000453:epidemiology* / Q000473:pathology; D015995:Prevalence; D012189:Retrospective Studies; D013548:Sweden / Q000453:epidemiology