Race, ethnicity, sex and temporal differences in Barrett's oesophagus diagnosis: a large community-based study, 1994-2006

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Abstract
Objective: To evaluate the demographics and incidence of Barrett’s oesophagus diagnosis using community-based data. Design: Observational study. Setting: Kaiser Permanente, Northern California healthcare membership, 1994–2006. Patients: Members with an electronic diagnosis of Barrett’s oesophagus. Main outcome measures: Incidence and prevalence of a new Barrett’s oesophagus diagnosis by race, sex, age and calendar year. Results: 4205 persons met the study definition for a diagnosis of Barrett’s oesophagus. The annual incidence in 2006 was highest among non-Hispanic whites (39/100 000 race-specific member-years, 95% confidence interval (95% CI) 35 to 43), with lower rates among Hispanics (22/100 000, 95% CI 16 to 29), Asians (16/100 000, 95% CI 11 to 22), and blacks (6/100 000, 95% CI 2 to 12). The annual incidence was higher among men than women (31 vs 17/100 000, respectively, year 2006; pConclusions: The demographic distributions of Barrett’s oesophagus differ markedly by race, age and sex and were comparable to those for oesophageal adenocarcinoma. Thus, demographic disparities in oesophageal adenocarcinoma risk may arise partly from the risk of having Barrett’s oesophagus, rather than from differing risks of progression from Barrett’s oesophagus to cancer. There has been an almost linear increase in the prevalence of diagnosed disease.