Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands.
Aliment Pharmacol Ther. 2014 Jun;39(11):1321-30. doi: 10.1111/apt.12759. Epub 2014 Apr 16.
Barrett's oesophagus (BO) is a risk factor for oesophageal adenocarcinoma (OAC). Several studies report increasing incidences of BO with substantial variation.
To determine age- and sex-stratified incidence rates (IR) of BO and OAC.
Cohort study using two primary care databases in the United Kingdom (UK) and the Netherlands (NL) (2000-2012). BO and OAC cases were identified using disease-specific READ codes (UK) and free-text search with manual validation (NL). Age- and sex-specific incidence rates (IRs) were calculated for both BO and OAC.
From the study population of 6,885,420 subjects in the UK, we identified 12,312 incident BO and 40 (0.3%) subsequent incident OAC cases. There were 1383 incident BO, and subsequent 5 (0.4%) incident OAC cases among the 1,487,191 subjects in the NL. The IR of BO increased linearly with age: 15.6/100,000 PYs (UK) and 23.7/100,000 PYs (NL) for patients aged 40-44 years, increasing to 85.6/100,000 PYs (UK) and 87.0/100,000 PYs (NL) for 70-74 years. In both the UK and the NL, IR of BO was 2-4 times higher in males than females across all age groups. With respect to calendar time, the IR of BO increased by 35% (UK) and 41% (NL) from 2000 to 2003, after which IRs remained stable until 2012.
The incidence rates of BO in the UK and the NL increased until 2003, but levelled off thereafter. Around 0.3% of patients with BO developed OAC at least 1 year after BO diagnosis. These findings may help tailor endoscopic surveillance strategies among patients with BO.
巴雷特食管（BO）是食管腺癌（OAC）的危险因素。多项研究报告称，BO 的发病率不断上升，且存在较大差异。
确定 BO 和 OAC 的年龄和性别分层发病率（IR）。
本研究采用英国（UK）和荷兰（NL）的两个初级保健数据库进行队列研究（2000-2012 年）。使用特定疾病的 READ 代码（UK）和带有手动验证的自由文本搜索（NL）识别 BO 和 OAC 病例。计算了 BO 和 OAC 的年龄和性别特异性发病率（IR）。
在 UK 的 6885420 名研究人群中，我们发现了 12312 例新发病例 BO 和 40 例（0.3%）随后发生的 OAC 病例。在 NL 的 1487191 名患者中，有 1383 例新发病例 BO 和随后的 5 例（0.4%）新发病例 OAC。BO 的发病率随年龄呈线性增加：40-44 岁患者为 15.6/100,000 PYs（英国）和 23.7/100,000 PYs（NL），增加到 70-74 岁患者的 85.6/100,000 PYs（英国）和 87.0/100,000 PYs（NL）。在英国和 NL，所有年龄段的男性 BO 发病率均为女性的 2-4 倍。就日历时间而言，2000 年至 2003 年，BO 的发病率在英国增加了 35%（NL），在 NL 增加了 41%，此后发病率一直保持稳定，直到 2012 年。
英国和 NL 的 BO 发病率在 2003 年之前一直在上升，但此后趋于平稳。大约 0.3%的 BO 患者在 BO 诊断后至少 1 年会发展为 OAC。这些发现可能有助于为 BO 患者量身定制内镜监测策略。
