The prevalence of Barrett Esophagus (BE) has progressively increased in recent years in western countries, and there is a trend of increasing incidence in China. The CiXian County is a high risk area for esophagus cancer. It has been about 30 years since the Project of Early Detection and Treatment for cancer was initiated there. The data of cancer registration had been included by Cancer Incidence in Five Continents (International Agency for Research on Cancer, IARC). However, no epidemiological data of BE has been reported.
From 2013 to 2014, residents officially registered by CiXian's authority aged between 40 and 69, were mobilized to participate in the screening project. The process followed the protocol of the Project of Early Detection and Management. All eligibile individuals took endoscopy. If any abnormal lesion was found, biopsies were taken for pathological examination. The diagnosis criteria were according to AGA criteria 2008. Demographic data and endoscopic characteristics were retrospectively analyzed.
Of 24,081 eligible residents, 5548 participated in the screening. The compliance rate was 23.04%. Of the 5548, 2319 were male, the other 3229 were female, giving a sex ratio of 0.72. The mean age was 53.57 ± 7.95. The mean BMI was 25.30 ± 3.41. 4481 accepted endoscopy, of which in 2484 biopsies were taken for further pathological examination. The rate of biopsy was 50.89%. 226 met the endoscopic diagnosis criteria of BE (4.63%), of which 118 were island types (52.21%), 75 were tongue types (33.19%), 33 were circumferential types (14.60%). In those endoscopic BE, only 4 were long segment BE (1.77%), the others were short segment (98.23%). 28 BE were pathologically confirmed. The detection rate of BE was 0.50%. Of those confirmed cases, 16 were male, the others female, the sex ratio was 1.33. The mean age was 56.36 ± 8.08, and the mean BMI was 24.87 ± 3.33. 15 had family history of cancer (53.57%). Only 5 had typical reflux symptoms (17.86%), 4 of which were diagnosed GERD according to GerdQ (14.28%).
Barrett esophagus is an important precancerous lesion in the high-risk area of North China. It's necessary fpr it to be brought into the Project of Early Detection and Management as a routine item.
Clinical trial identification
Legal entity responsible for the study
China-Japan Friendship Hospital
Ministry of Science and Technology of People's Republic of China
All authors have declared no conflicts of interest.