title: Prevalence of Barrett's esophagus in the general population: an endoscopic study.
abstract: OBJECTIVE
  Barrett's esophagus (BE) is associated with esophageal adenocarcinoma, the incidence of which has been increasing dramatically. The prevalence of BE in the general population is uncertain because upper endoscopy is required for diagnosis. This study aimed to determine the prevalence of BE and possible associated risk factors in an adult Swedish population.
  
  
  METHODS
  A random sample (n = 3000) of the adult population (n = 21,610) in 2 municipalities was surveyed using a validated gastrointestinal symptom questionnaire (response rate, 74%); a random subsample (n = 1000; mean age, 53.5 years; 51% female) underwent upper endoscopy. Endoscopic signs suggestive of columnar-lined esophagus (CLE) were defined as mucosal tongues or an upward shift of the squamocolumnar junction. BE was diagnosed when specialized intestinal metaplasia was detected histologically in suspected CLE.
  
  
  RESULTS
  BE was present in 16 subjects (1.6%; 95% confidence interval, 0.8-2.4): 5 with a long segment and 11 with a short segment. Overall, 40% reported reflux symptoms and 15.5% showed esophagitis; 103 (10%) had suspected CLE, and 12 (1.2%) had a visible segment > or = 2 cm. The prevalence of BE in those with reflux symptoms was 2.3% and in those without reflux symptoms was 1.2% (P = .18). In those with esophagitis, the prevalence was 2.6%; in those without, the prevalence was 1.4% (P = .32). Alcohol (P = .04) and smoking (P = .047) were independent risk factors for BE.
  
  
  CONCLUSIONS
  BE was found in 1.6% of the general Swedish population. Alcohol and smoking were significant risk factors.
authors.affiliation: Centre for Family Medicine, Karolinska Institutet, Stockholm, Sweden. jukka.ronkainen@fimnet.fi
authors.forename: Jukka
authors.initials: J
authors.lastname: Ronkainen
authors.forename: Pertti
authors.initials: P
authors.lastname: Aro
authors.forename: Tom
authors.initials: T
authors.lastname: Storskrubb
authors.forename: Sven-Erik
authors.initials: SE
authors.lastname: Johansson
authors.forename: Tore
authors.initials: T
authors.lastname: Lind
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Bolling-Sternevald
authors.forename: Michael
authors.initials: M
authors.lastname: Vieth
authors.forename: Manfred
authors.initials: M
authors.lastname: Stolte
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Talley
authors.forename: Lars
authors.initials: L
authors.lastname: Agréus
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000503:physiopathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking; D001471:Barrett Esophagus / Q000175:diagnosis* / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D001706:Biopsy; D004724:Endoscopy; D004938:Esophageal Neoplasms / Q000473:pathology / Q000503:physiopathology; D004947:Esophagus / Q000473:pathology*; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012907:Smoking; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology