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.
Park
Jong-Jae
JJ
Department of Internal Medicine, Korea University College of Medicine, Korea.
Kim
Jae Woo
JW
Kim
Hyun Jin
HJ
Chung
Moon Gi
MG
Park
Seon Mee
SM
Baik
Gwang Ho
GH
Nah
Byung Kyu
BK
Nam
Su Youn
SY
Seo
Kang Seok
KS
Ko
Byung Sung
BS
Jang
Jae-Young
JY
Kim
Byeong Gwan
BG
Kim
Ji Won
JW
Choi
Youn Seon
YS
Joo
Moon Kyung
MK
Kim
Jin Il
JI
Cho
Mee-Yon
MY
Kim
Nayoung
N
Park
Soo-Heon
SH
Jung
Hyun Chae
HC
Chung
In-Sik
IS
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