Barrett's oesophagus and oesophageal cancer in Saudi Arabia.

BACKGROUND/AIMS: Gastrooesophageal reflux disease (GERD) and Barrett's oesophagus (BE) are presumed to be rare among non-western populations. This retrospective survery determined the prevalence of BE and its associated complications of dysplastic lesions (DL) and oesophageal adenocarcinoma (AD) among an Arabian population.

METHODOLOGY

From 2572 patients who had endoscopy in King Fahd Central Hospital (KFCH) Gizan, Saudi Arabia, patients (n = 776) were selected for analysis if they had biopsies of the upper gastrointestinal (UGI) tract. The patients (159 of 776) with biopsy-proven oesophageal lesions were categorized and compared.

RESULTS

The relative frequencies of BE, DL and AD in 159 patients were 8(5%), 5(3%) and 16 (10%) respectively. These interpreted to prevalence rates of 0.31%, 1.9%, and 0.62% for the respective lesions. The comparison of the mean age +/- SD (in years) of the patients with BE (59.6 +/- 19.8), DL (66 +/- 16.7) and AD (70.6 +/- 12.2) showed to statistically significant difference. Major symptoms in the patients with BE were dyspepsia (4 cases), hematemesis (2 cases) and dysphagia (2 cases). This profile was not different from that observed in 79 patients with GERD.

CONCLUSION

The prevalence of 0.31% in our endoscopy population is at the lower range of the 0.3% to 10% reported in the western world. It is likely that the rate was underestimated by this retrospective survey, in which patients were selectively biopsied. Also, it is probable that the majority of individuals in our population with no or minimal symptoms of GERD do not present themselves or are not referred for evaluation. Despite this limitation, our study confirms the occurrence of BE and its complications among a Saudi population. The incidence of BE may increase with the current changes in the life-style and increase in the life-span of the Saudi Arabian population.