Systematic review and meta-analysis of prevalence and risk factors for Barrett's esophagus

Bashar J. Qumseya, Aymen Bukannan, Sherif Gendy, Yahya Ahemd, Shahnaz Sultan, Paul Bain, Seth A. Gross, Prasad G Iyer, Sachin Wani

Research output: Contribution to journalReview article

1 Citation (Scopus)

Abstract

Background and Aims: Although screening for Barrett's esophagus (BE) is recommended in individuals with multiple risk factors, the type and number of risk factors necessary to trigger screening is unclear. In this systematic review and meta-analysis, we aimed to assess the relationship between number of risk factors and prevalence of BE. Methods: Through October 17, 2018 we searched studies that described the prevalence of BE in the general population and based on presence of risk factors that included GERD, male gender, age >50 years, family history of BE and esophageal adenocarcinoma, and obesity (defined as body mass index >35). Risk of BE based on number of risk factors was assessed using meta-regression while controlling for potential confounders. Results: Of 2741 studies, 49 were included in the analysis (307,273 individuals, 1948 with biopsy specimen–proven BE). Indications varied by study. The prevalence of BE for various populations was as follows: low-risk general population,.8% (95% confidence interval [CI],.6%-1.1%); GERD, 3% (95% CI, 2.3%-4%); GERD plus presence of any other risk factor, 12.2% (95% CI, 10.2%-14.6%); family history, 23.4% (95% CI, 13.7% -37.2%); age >50, 6.1% (95% CI, 4.6%-8.1%); obesity, 1.9% (95% CI, 1.2%-3%); and male sex, 6.8% (95% CI, 5.3%-8.6%). Prevalence of BE varied significantly between Western and non-Western populations. In a meta-regression, controlling for the region of the study, age, and gender, there was a positive linear relationship between the number of risk factors and the prevalence of BE. Conclusions: Results of this study provide estimates of BE prevalence based on the presence and the number of risk factors. These results add credence to current guidelines that suggest screening in the presence of multiple risk factors.

Original languageEnglish (US)
JournalGastrointestinal endoscopy
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Barrett Esophagus
Meta-Analysis
Confidence Intervals
Gastroesophageal Reflux
Population
Obesity
Adenocarcinoma
Body Mass Index
Cross-Sectional Studies
Guidelines
Biopsy

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

Qumseya, B. J., Bukannan, A., Gendy, S., Ahemd, Y., Sultan, S., Bain, P., ... Wani, S. (Accepted/In press). Systematic review and meta-analysis of prevalence and risk factors for Barrett's esophagus. Gastrointestinal endoscopy. https://doi.org/10.1016/j.gie.2019.05.030

Systematic review and meta-analysis of prevalence and risk factors for Barrett's esophagus. / Qumseya, Bashar J.; Bukannan, Aymen; Gendy, Sherif; Ahemd, Yahya; Sultan, Shahnaz; Bain, Paul; Gross, Seth A.; Iyer, Prasad G; Wani, Sachin.

In: Gastrointestinal endoscopy, 01.01.2019.

Research output: Contribution to journalReview article

Qumseya, Bashar J. ; Bukannan, Aymen ; Gendy, Sherif ; Ahemd, Yahya ; Sultan, Shahnaz ; Bain, Paul ; Gross, Seth A. ; Iyer, Prasad G ; Wani, Sachin. / Systematic review and meta-analysis of prevalence and risk factors for Barrett's esophagus. In: Gastrointestinal endoscopy. 2019.
@article{6ca00fe9ae7d49e6a7503785c2feebc7,
title = "Systematic review and meta-analysis of prevalence and risk factors for Barrett's esophagus",
abstract = "Background and Aims: Although screening for Barrett's esophagus (BE) is recommended in individuals with multiple risk factors, the type and number of risk factors necessary to trigger screening is unclear. In this systematic review and meta-analysis, we aimed to assess the relationship between number of risk factors and prevalence of BE. Methods: Through October 17, 2018 we searched studies that described the prevalence of BE in the general population and based on presence of risk factors that included GERD, male gender, age >50 years, family history of BE and esophageal adenocarcinoma, and obesity (defined as body mass index >35). Risk of BE based on number of risk factors was assessed using meta-regression while controlling for potential confounders. Results: Of 2741 studies, 49 were included in the analysis (307,273 individuals, 1948 with biopsy specimen–proven BE). Indications varied by study. The prevalence of BE for various populations was as follows: low-risk general population,.8{\%} (95{\%} confidence interval [CI],.6{\%}-1.1{\%}); GERD, 3{\%} (95{\%} CI, 2.3{\%}-4{\%}); GERD plus presence of any other risk factor, 12.2{\%} (95{\%} CI, 10.2{\%}-14.6{\%}); family history, 23.4{\%} (95{\%} CI, 13.7{\%} -37.2{\%}); age >50, 6.1{\%} (95{\%} CI, 4.6{\%}-8.1{\%}); obesity, 1.9{\%} (95{\%} CI, 1.2{\%}-3{\%}); and male sex, 6.8{\%} (95{\%} CI, 5.3{\%}-8.6{\%}). Prevalence of BE varied significantly between Western and non-Western populations. In a meta-regression, controlling for the region of the study, age, and gender, there was a positive linear relationship between the number of risk factors and the prevalence of BE. Conclusions: Results of this study provide estimates of BE prevalence based on the presence and the number of risk factors. These results add credence to current guidelines that suggest screening in the presence of multiple risk factors.",
author = "Qumseya, {Bashar J.} and Aymen Bukannan and Sherif Gendy and Yahya Ahemd and Shahnaz Sultan and Paul Bain and Gross, {Seth A.} and Iyer, {Prasad G} and Sachin Wani",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.gie.2019.05.030",
language = "English (US)",
journal = "Gastrointestinal Endoscopy",
issn = "0016-5107",
publisher = "Mosby Inc.",

}

TY - JOUR

T1 - Systematic review and meta-analysis of prevalence and risk factors for Barrett's esophagus

AU - Qumseya, Bashar J.

AU - Bukannan, Aymen

AU - Gendy, Sherif

AU - Ahemd, Yahya

AU - Sultan, Shahnaz

AU - Bain, Paul

AU - Gross, Seth A.

AU - Iyer, Prasad G

AU - Wani, Sachin

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background and Aims: Although screening for Barrett's esophagus (BE) is recommended in individuals with multiple risk factors, the type and number of risk factors necessary to trigger screening is unclear. In this systematic review and meta-analysis, we aimed to assess the relationship between number of risk factors and prevalence of BE. Methods: Through October 17, 2018 we searched studies that described the prevalence of BE in the general population and based on presence of risk factors that included GERD, male gender, age >50 years, family history of BE and esophageal adenocarcinoma, and obesity (defined as body mass index >35). Risk of BE based on number of risk factors was assessed using meta-regression while controlling for potential confounders. Results: Of 2741 studies, 49 were included in the analysis (307,273 individuals, 1948 with biopsy specimen–proven BE). Indications varied by study. The prevalence of BE for various populations was as follows: low-risk general population,.8% (95% confidence interval [CI],.6%-1.1%); GERD, 3% (95% CI, 2.3%-4%); GERD plus presence of any other risk factor, 12.2% (95% CI, 10.2%-14.6%); family history, 23.4% (95% CI, 13.7% -37.2%); age >50, 6.1% (95% CI, 4.6%-8.1%); obesity, 1.9% (95% CI, 1.2%-3%); and male sex, 6.8% (95% CI, 5.3%-8.6%). Prevalence of BE varied significantly between Western and non-Western populations. In a meta-regression, controlling for the region of the study, age, and gender, there was a positive linear relationship between the number of risk factors and the prevalence of BE. Conclusions: Results of this study provide estimates of BE prevalence based on the presence and the number of risk factors. These results add credence to current guidelines that suggest screening in the presence of multiple risk factors.

AB - Background and Aims: Although screening for Barrett's esophagus (BE) is recommended in individuals with multiple risk factors, the type and number of risk factors necessary to trigger screening is unclear. In this systematic review and meta-analysis, we aimed to assess the relationship between number of risk factors and prevalence of BE. Methods: Through October 17, 2018 we searched studies that described the prevalence of BE in the general population and based on presence of risk factors that included GERD, male gender, age >50 years, family history of BE and esophageal adenocarcinoma, and obesity (defined as body mass index >35). Risk of BE based on number of risk factors was assessed using meta-regression while controlling for potential confounders. Results: Of 2741 studies, 49 were included in the analysis (307,273 individuals, 1948 with biopsy specimen–proven BE). Indications varied by study. The prevalence of BE for various populations was as follows: low-risk general population,.8% (95% confidence interval [CI],.6%-1.1%); GERD, 3% (95% CI, 2.3%-4%); GERD plus presence of any other risk factor, 12.2% (95% CI, 10.2%-14.6%); family history, 23.4% (95% CI, 13.7% -37.2%); age >50, 6.1% (95% CI, 4.6%-8.1%); obesity, 1.9% (95% CI, 1.2%-3%); and male sex, 6.8% (95% CI, 5.3%-8.6%). Prevalence of BE varied significantly between Western and non-Western populations. In a meta-regression, controlling for the region of the study, age, and gender, there was a positive linear relationship between the number of risk factors and the prevalence of BE. Conclusions: Results of this study provide estimates of BE prevalence based on the presence and the number of risk factors. These results add credence to current guidelines that suggest screening in the presence of multiple risk factors.

UR - http://www.scopus.com/inward/record.url?scp=85071648513&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85071648513&partnerID=8YFLogxK

U2 - 10.1016/j.gie.2019.05.030

DO - 10.1016/j.gie.2019.05.030

M3 - Review article

C2 - 31152737

AN - SCOPUS:85071648513

JO - Gastrointestinal Endoscopy

JF - Gastrointestinal Endoscopy

SN - 0016-5107

ER -