Endoscopy 2020; 52(S 01): S129-S130
DOI: 10.1055/s-0040-1704398
ESGE Days 2020 oral presentations
Saturday, April 25, 2020 11:00 – 13:00 Esophageal therapy: No limits?! Wicklow Meeting Room 3
© Georg Thieme Verlag KG Stuttgart · New York

ESTIMATING THE GLOBAL PREVALENCE OF BARRETT’S ESOPHAGUS: A SYSTEMATIC REVIEW OF PUBLISHED STUDIES

I Marques de Sá
1   Instituto Português de Oncologia, Gastroenterology, Porto, Portugal
,
P Marcos
2   Centro Hospitalar de Leiria, Gastroenterology, Leiria, Portugal
,
P Sharma
3   Kansas City Veterans Affairs Medical Center, Gastroenterology, Kansas, U S A
,
MD Ribeiro
1   Instituto Português de Oncologia, Gastroenterology, Porto, Portugal
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

Also available at
 
 

    Aims Determining the prevalence of Barrett’s esophagus (BE) is of paramount importance for defining screening strategies and health-services resource utilization. However, precise estimates of prevalence are not clear with existing published data reporting a wide range of prevalence. We aimed to synthesize the available data, determine BE prevalence and assess variability according to definition (namely to the most recent guidelines), geographical region, time period and methodology.

    Methods Three databases (PubMed, Scopus and Web of Knowledge) were searched for manuscripts addressing the prevalence of BE. Subgroup, sensitivity and meta-regression analysis were conducted to explore heterogeneity. Pooled prevalence was computed using random-effect model.

    Results Of 3510 studies from the initial search, 110 were included (63 in general population, 2 in asymptomatic population, 22 in gastro-esophageal reflux disease, 10 in other symptoms and 13 in specific populations) in the final analysis. The prevalence of BE varied depending on the population and definition used. In GERD, the pooled prevalence of BE with IM was 7.46%[CI95%:5.79;8.13]. In general population, the pooled prevalence of BE with intestinal metaplasia (IM) was 0.87%[CI95%:0.75-0.99]; BE > 1 cm was [0.82(CI95%:0.61;1.02) vs BE of any length was 2.81(CI95%:1.81;3.82)]. The pooled prevalence significantly increased to 4.86%[CI95%:2.70;7.02] when considering any columnar epithelium and to 7.04%[CI95%:6.35;7.74] when considering endoscopic suspicion of BE irrespective of length. Even though the high heterogeneity and high risk for biases, there was a gradient East-West, North-South and a time-trend in BE prevalence with differences in the estimation of BE prevalence after and before Prague classification [after:0.65(CI95%:0.54;0.77) vs before:2.38(CI95%:1.96;2.79)]. The study design did not influence estimations. Studies assessing population’s cohort/sample had lower BE prevalence than studies assessing patients undergoing endoscopy.

    Conclusions There is a need to reassess true estimates of the prevalence of BE using the current guidelines in most regions. Of this, diverse attitudes will depend from educational activities to screening programmes.


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