title: Prevalence of upper gastrointestinal endoscopic findings in the community: A systematic review of studies in unselected samples of subjects.
abstract: OBJECTIVE
  Upper gastrointestinal endoscopic findings, such as esophagitis, Barrett's esophagus, peptic ulcer, and malignancy, represent a public health problem. This systematic review aimed to evaluate the prevalence of upper gastrointestinal endoscopic findings in the community.
  
  
  METHODS
  A systematic search was conducted in PUBMED and EMBASE to May 2015. Studies were eligible if they reported the prevalence of upper gastrointestinal endoscopic findings in unselected samples of the community.
  
  
  RESULTS
  Twelve articles were eligible, nine reported data from three endoscopic surveys (n = 3063 subjects), and three from national screening programs (n = 84 153). The overall prevalence of upper gastrointestinal endoscopic findings in the community was 30% in the Kalixanda study (Sweden), 24.9% in the Loiano-Monghidoro study (Italy), and 68.9% in the Systematic Investigation of Gastrointestinal Diseases study (China). The pooled prevalence of esophagitis, endoscopically suspected esophageal metaplasia (ESEM), peptic ulcer, and gastric cancer in all studies was 11.2, 5.1, 6.8, and 0.33%, respectively. The most frequent finding was esophagitis in Europe, with a prevalence of 15.5% in Sweden and 11.8% in Italy, and peptic ulcer in China (17.1%), both in asymptomatic and symptomatic individuals. The prevalence of Helicobacter pylori was positively associated with the prevalence of peptic ulcer (r = 0.91) but negatively associated with the prevalence of both esophagitis (r = -0.99) and ESEM (r = -0.95).
  
  
  CONCLUSIONS
  Upper gastrointestinal endoscopic findings are present in at least a quarter of subjects in the community with different patterns in Western and Eastern countries, both in asymptomatic and symptomatic subjects. H. pylori prevalence negatively impacts on the prevalence of reflux-related esophageal findings.
authors: Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy. roccomaurizio.zagari@unibo.it.|Gastroenterology Unit, S.Orsola-Malpighi Hospital, Bologna, Italy. roccomaurizio.zagari@unibo.it.
authors: Rocco Maurizio
authors: RM
authors: Zagari
authors: Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.|Gastroenterology Unit, S.Orsola-Malpighi Hospital, Bologna, Italy.
authors: Leonardo Henry
authors: LH
authors: Eusebi
authors: Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.|Gastroenterology Unit, S.Orsola-Malpighi Hospital, Bologna, Italy.
authors: Stefano
authors: S
authors: Rabitti
authors: Section of Diseases, Department of Surgery and Translational Medicine, University of Milano-Bicocca, Monza, Italy.
authors: Laura
authors: L
authors: Cristoferi
authors: Gastroenterology Unit, S.Orsola-Malpighi Hospital, Bologna, Italy.
authors: Amanda
authors: A
authors: Vestito
authors: Gastroenterology Unit, S.Orsola-Malpighi Hospital, Bologna, Italy.
authors: Nico
authors: N
authors: Pagano
authors: Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.|Gastroenterology Unit, S.Orsola-Malpighi Hospital, Bologna, Italy.
authors: Franco
authors: F
authors: Bazzoli
mesh_terms: D001471:Barrett Esophagus / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D016481:Helicobacter Infections / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D016480:Helicobacter pylori; D006801:Humans; D010437:Peptic Ulcer / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D015995:Prevalence; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology
keywords: Helicobacter pylori; epidemiology; upper gastrointestinal endoscopic findings