Temporal trends of esophageal disorders by age in the Cerner Health Facts database.

PURPOSE

Esophageal adenocarcinoma incidence has increased approximately 600% over the last 4 decades in the United States. Little research has been conducted on the temporal trends of gastroesophageal reflux disease (GERD) and Barrett's esophagus (BE), yet it is important to establish whether these conditions have also increased with time or differ by age.

METHODS

The Cerner Health Facts(®) database contains information on 35 million patients between 2001 and 2010. GERD, BE, and esophageal cancer (EC) cases were defined using International Classification of Diseases, ninth edition codes. We calculated age-adjusted rates and 95% confidence intervals for GERD, BE, and EC.

RESULTS

In this population, the overall, all-age rate per 100,000 encounters for GERD was 711.9, BE was 21.6, and EC was 6.1. During 2001-2010, GERD rates increased by approximately 50% and EC rates more than doubled, but BE rates declined by approximately 40%. Trends were similar by age, and all rates were higher in Caucasians and males.

CONCLUSIONS

These data indirectly support the idea that increased incidence of EC may be partially due to GERD and raise the provocative hypothesis that BE rates may be decreasing possibly as a forerunner of continued stabilization of esophageal adenocarcinoma rates and a possible subsequent decline.