The prevalence of and risk factors for Barrett's esophagus in a Korean population: A nationwide multicenter prospective study.
OBJECTIVE
The aim of this study was to evaluate the prevalence of Barrett's esophagus (BE) in the general Korean population by evaluating screening esophagogastroduodenoscopy. In addition, the risk factors for BE were identified.


METHODS
An esophagogastroduodenoscopy examination was performed in 25,536 subjects who had upper endoscopy screening from January 2006 to July 2006.


RESULTS
Two hundred and fifteen subjects were confirmed to have BE by pathology, thus the prevalence of BE was calculated to be 0.84%. The endoscopic findings were subdivided into 2 groups: BE without reflux esophagitis (RE), which included 167 (77.7%), and BE with RE, which included 48 (22.3%). The analysis of symptoms showed that only 60.1% of the subjects with BE had reflux symptoms. Chest pain [odds ratio (OR): 1.48, 95% confidence interval (CI): 1.04-2.11] and epigastric soreness (OR: 1.42, 95% CI: 1.05-1.93) were found more frequently in the subjects with BE compared with the normal subjects. The multivariate analysis showed that the risk factors for all subjects with BE were a male sex (OR: 1.82, 95% CI: 1.32-2.50), nonsteroidal anti-inflammatory drug use (OR: 2.02, 95% CI: 1.28-3.20), hiatal hernia (OR: 5.66, 95% CI: 3.70-8.66), and an age > or = 60 compared with an age < 40 (OR: 1.81, 95% CI: 1.07-3.09). There was no significant difference associated with RE.


CONCLUSIONS
The prevalence of BE in Korean patients presenting for a routine health check-up was 0.84%, lower than reported in Western countries. Among the subjects with BE 77.7% did not have endoscopic erosions and there were no reflux symptoms in 39.9%. These results suggest that regular endoscopic screening with a high index of suspicion is necessary for the diagnosis of BE.
Department of Internal Medicine, Korea University College of Medicine, Korea.
Jong-Jae
JJ
Park
Jae Woo
JW
Kim
Hyun Jin
HJ
Kim
Moon Gi
MG
Chung
Seon Mee
SM
Park
Gwang Ho
GH
Baik
Byung Kyu
BK
Nah
Su Youn
SY
Nam
Kang Seok
KS
Seo
Byung Sung
BS
Ko
Jae-Young
JY
Jang
Byeong Gwan
BG
Kim
Ji Won
JW
Kim
Youn Seon
YS
Choi
Moon Kyung
MK
Joo
Jin Il
JI
Kim
Mee-Yon
MY
Cho
Nayoung
N
Kim
Soo-Heon
SH
Park
Hyun Chae
HC
Jung
In-Sik
IS
Chung
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D001471:Barrett Esophagus / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D002637:Chest Pain / Q000209:etiology; D016145:Endoscopy, Digestive System / Q000379:methods*; D004942:Esophagitis, Peptic / Q000209:etiology*; D005260:Female; D006551:Hernia, Hiatal / Q000150:complications; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D055815:Young Adult
D000894:Anti-Inflammatory Agents, Non-Steroidal