title: Barrett's esophagus in Latinos undergoing endoscopy for gastroesophageal reflux disease symptoms.
abstract: Previous studies comparing the prevalence of Barrett's esophagus in Latinos and non-Latino whites are inconsistent. The aim of the study is to compare the prevalence of Barrett's esophagus in Latinos and non-Latino whites and to determine risk factors associated with Barrett's esophagus. Between March 2005 and January 2009, consecutive Latino and non-Latino white patients who underwent endoscopy for primary indication for symptoms of gastroesophageal reflux disease were identified by examining the internal endoscopy database at Los Angeles County + USC Medical Center. Barrett's esophagus was defined by columnar-lined distal esophagus on endoscopy confirmed by intestinal metaplasia on histology. Clinical features and endoscopic findings were retrospectively reviewed. The mean age of the 663 patients was 50 ± 12 years, 30% were male, and 92% were Latino. Compared with non-Latino whites, Latinos had more females (72% vs. 46%; P = 0.0001) and more Helicobacter pylori infection (53% vs. 24%; P = 0.003) but less tobacco use (7% vs. 17%; P = 0.01). Overall, 10% (68/663) of all patients had Barrett's esophagus whereas the prevalence was 10% (62/611) among the Latinos and 12% (6/52) among the non-Latino whites (OR 0.9, 95% CI 0.4-2.1; P = 0.75). One patient in the Latino group had high-grade dysplasia. On multivariate analysis, male gender (AOR 2.3, 95% CI 1.4-4.1; P = 0.002), diabetes (AOR 2.2, 95% CI 1.1-4.5; P = 0.03), and age ≥55 years (AOR 2.2, 95% CI 1.3-3.8; P = 0.006) were independently associated with Barrett's esophagus; Latino ethnicity remained nonsignificant (AOR 1.1, 95% CI 0.4-2.7; P = 0.88). In Latinos undergoing endoscopy for gastroesophageal reflux disease symptoms, the prevalence of Barrett's esophagus was 10%, comparable with non-Latino white controls as well as the prevalence previously reported among Caucasians. In addition to established risk factors, diabetes was associated with Barrett's esophagus.
authors.affiliation: Division of Gastrointestinal and Liver Diseases Department of Pathology, University of Southern California, Los Angeles, CA, USA.
authors.forename: K
authors.initials: K
authors.lastname: Keyashian
authors.forename: V
authors.initials: V
authors.lastname: Hua
authors.forename: K
authors.initials: K
authors.lastname: Narsinh
authors.forename: M
authors.initials: M
authors.lastname: Kline
authors.forename: P T
authors.initials: PT
authors.lastname: Chandrasoma
authors.forename: J J
authors.initials: JJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D001471:Barrett Esophagus / Q000175:diagnosis* / Q000208:ethnology* / Q000473:pathology; D002140:California / Q000453:epidemiology; D016001:Confidence Intervals; D016208:Databases, Factual; D003937:Diagnosis, Differential; D004945:Esophagoscopy / Q000379:methods; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000208:ethnology / Q000473:pathology; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011230:Precancerous Conditions / Q000175:diagnosis* / Q000208:ethnology / Q000473:pathology; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D044465:White People / Q000706:statistics & numerical data