Screening for Barrett's esophagus in asymptomatic women.

BACKGROUND

Barrett's esophagus (BE) has been detected in approximately 10% of patients with chronic GERD. Previous studies demonstrated a similar prevalence of BE in asymptomatic adults.

OBJECTIVE

To determine the prevalence of BE in asymptomatic women.

DESIGN

We invited women scheduled for routine screening colonoscopy (for colorectal cancer) and women undergoing endoscopic examination before bariatric surgery to participate. Patients experiencing heartburn symptoms more than once per month were excluded.

SETTING

Outpatients at Stanford University and Palo Alto VA Health Care System.

INTERVENTIONS

Biopsies of the esophagogastric junction in the setting of suspected BE, and completion of symptom and health-related quality of life questionnaires to ensure that subjects were asymptomatic.

MAIN OUTCOME MEASUREMENT

Identification of BE.

RESULTS

We detected BE in 8 (6%) of 126 subjects, including 3 (5%) of 61 of the women in the colorectal cancer screening cohort and 5 (8%) of 65 of the women in the pre-bariatric surgery cohort, all of whom had BE measuring 2 cm or less (P = .30). Patients found to have BE were more likely to be older (mean age 60 years vs 49 years, respectively; P = .04), but there was no difference in mean body mass index, ethnicity, or tobacco or alcohol use between patients with and without BE. BE was only present in pre-bariatric surgery subjects younger than the age of 50 and was most common in the 61- to 70-year age cohort in both groups. Erosive esophagitis, microscopic reflux changes, and Helicobacter pylori infection were not more common in the pre-bariatric surgery group.

LIMITATION

Small number of subjects with BE detected.

CONCLUSIONS

Short-segment BE was detected in 6% of asymptomatic women undergoing screening endoscopic examinations.