Open AccessRisk stratifying the screening of Barrett's esophagus: An Asian perspective
Author(s) -
Sharma Neel,
Hui Tianyi,
Wong Hung C,
Srivastava Supriya,
Teh Ming,
Yeoh Khay G,
Ho Khek Y
Publication year - 2017
Publication title -
jgh open
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.546
H-Index - 8
ISSN - 2397-9070
DOI - 10.1002/jgh3.12013
Subject(s) - medicine , odds ratio , intestinal metaplasia , esophagus , confidence interval , barrett's esophagus , gastroenterology , metaplasia , cancer , demographics , adenocarcinoma , demography , sociology
Background and Aim Barrett's esophagus (BE) is a premalignant condition for esophageal adenocarcinoma. Although risk factors exist for screening patients in the West, we aimed to determine the factors in terms of demographics and symptoms for patients in an Asian setting. Methods We recruited 1378 patients over a 7‐year period as part of an ongoing gastric cancer screening program. An appropriately designed questionnaire was utilized to determine the necessary risk factors and symptoms with endoscopic analysis and subsequent histological confirmation as the gold standard. We utilized the existence of intestinal metaplasia of the distal esophagus as the primary diagnostic pathology. Results We demonstrated that no symptoms were indicative of BE in an Asian setting. Age (odds ratio 1.081, 95% confidence interval 1.022–1.143) and male gender (odds ratio 4.808, 95% confidence interval 1.727–13.33) proved significant demographic factors for the presence of intestinal metaplasia ( P 0.007, 0.003, respectively). Conclusions We advocate the utilization of increasing age and male gender as the primary risk factors for patients at risk of BE. We also recommend astute examination of the distal esophagus whilst patients undergo simultaneous gastric cancer screening.