Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
J Gastroenterol Hepatol. 2011 May;26(5):816-24. doi: 10.1111/j.1440-1746.2011.06669.x.
Gastroesophageal reflux disease (GERD) is a known predisposing factor for Barrett's esophagus. Amongst individuals with symptomatic GERD, the prevalence of Barrett esophagus is estimated to be more than 10%, and an individual with Barrett's esophagus is more likely than the general population to develop esophageal adenocarcinoma. In Western Europe and North America, incidence of esophageal adenocarcinoma had been on the upward trend for many decades. In comparison, although the prevalence of GERD and reflux esophagitis has increased several fold in some parts of Asia, the prevalence of esophageal adenocarcinoma and Barrett's esophagus remains generally low in the region. Rising incidence of esophageal adenocarcinoma has been observed in regions witnessing increasing prevalence of GERD. If the recent increase in prevalence of GERD in parts of urbanized Asia is any indication of the beginning of an upsurge in the incidence of Barrett's esophagus and associated adenocarcinoma, would we be witnessing a pattern of epidemiological shift mirroring that in the West? Given that more than 90% of Barrett's esophagus in Asian patients is of the short-segment type, which is reported to have lesser propensity to develop to adenocarcinoma, could the ongoing epidemiologic transition take Asia on the same trail as that which the West has taken? This article will draw on relevant findings from various parts of Asia and take an in-depth look at prevailing disease trends to see where Asia stands now in the changing epidemiology of GERD, Barrett's esophagus and associated adenocarcinoma.
胃食管反流病（GERD）是 Barrett 食管的已知诱发因素。在有症状性 GERD 的人群中，估计 Barrett 食管的患病率超过 10%，而患有 Barrett 食管的个体比一般人群更有可能发展为食管腺癌。在西欧和北美，食管腺癌的发病率几十年来一直呈上升趋势。相比之下，尽管亚洲部分地区的 GERD 和反流性食管炎的患病率增加了数倍，但该地区食管腺癌和 Barrett 食管的患病率总体仍然较低。在 GERD 患病率增加的地区，食管腺癌的发病率也有所上升。如果亚洲部分城市化地区最近 GERD 患病率的增加是 Barrett 食管和相关腺癌发病率上升的开始，我们是否会看到与西方类似的流行病学转变模式？鉴于亚洲患者中超过 90%的 Barrett 食管为短节段型，据报道其发展为腺癌的倾向较小，正在进行的流行病学转变是否会使亚洲走上与西方相同的道路？本文将借鉴亚洲各地的相关发现，并深入探讨当前的疾病趋势，以了解亚洲在 GERD、Barrett 食管和相关腺癌的不断变化的流行病学中所处的位置。
