Prevalence and risk factors of Barrett's esophagus in Korea

Barrett's esophagus (BE) is diagnosed when specialized intestinal metaplasia (SIM) is detected histologically in endoscopically suspected columnar-lined esophagus (CLE). It is a premalignant condition and plays a pivotal role in the development of esophageal adenocarcinoma. It has traditionally been believed to affect Asians less frequently. The aim of this study was to determine the prevalence of BE and possible associated risk factors in Korea.

A retrospective analysis of 70 103 patients who had undergone their first upper endoscopies was performed using computerized medical records. Of these, 696 (1%) patients had suspected CLE. After screening by telephone, 480 were enrolled. The clinical and endoscopic characteristics of histologically identifiable BE and endoscopically suspected CLE not confirmed by biopsy (suspected CLE without SIM) were investigated.

Barrett's esophagus was present in 151 patients (0.22%) with a mean age of 53.8 +/- 10.9 years. BE was more commonly found in men. BE was associated with a set of features distinct from suspected CLE without SIM; older age, greater predominance of male sex, more frequent smoking history, and more frequent acid regurgitation symptom.

Barrett's esophagus remains less common in Korea than in Western countries. Old age, male sex, smoking, and acid regurgitation symptom were significant risk factors.