Skip to main content

Advertisement

SpringerLink
Log in

African Americans with Barrett’s Esophagus Are Less Likely to Have Dysplasia at Biopsy

  • Original Article
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Background

Barrett’s Esophagus (BE) is a pre-malignant condition. Limited data on BE dysplasia prevalence exists among United States ethnic groups.

Aim

The purpose of this study was to determine if the frequency of BE with dysplasia varies among the major ethnic groups presenting to our institution.

Methods

The University of Florida-Jacksonville endoscopy database was searched for all cases of endoscopic BE from September 2002 to August 2007. Histologic BE was diagnosed if salmon colored esophageal mucosa was endoscopically seen at least 1 cm above the top of the gastric folds and biopsy revealed intestinal metaplasia with Alcian blue-containing goblet cells. Demographic data collected for all included: age at diagnosis, ethnicity, sex, previous history of esophageal reflux, atypical manifestations (chronic cough, aspiration), endoscopic length of BE, presence or absence of hiatal hernia, esophageal stricture or ulcer, and presence or absence of dysplasia.

Results

Salmon colored esophageal mucosa was observed in 405 of 7,308 patients (5.5%) and histologically confirmed in 115 of 405 patients (28%) reflecting an overall prevalence of BE of 115/7308 (1.6%) in this cohort. Ethnic distribution of histologic BE patients was as follows: 95 (83%) non-Hispanic white (nHw), 16 (14%) African American (AA) and 4 (3%) other. Long segment BE (LSBE) and any form of dysplasia was observed less frequently in AA than nHw (LSBE: 12% vs. 26% and dysplasia: 0% vs. 7%).

Conclusions

LSBE and dysplasia are less frequent in AA than nHw. Studies in AA with BE may illustrate factors limiting dysplasia and LSBE risk.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. El-Serag HB, Mason AC, Petersen N, et al. Epidemiological differences between adenocarcinoma of the oesophagus and adenocarcinoma of the gastric cardia in the USA. Gut. 2002;50:368–372.

    Article  PubMed  CAS  Google Scholar 

  2. Kubo A, Corley DA. Marked multi-ethnic variation of esophageal and gastric cardia carcinomas within the United States. Am J Gastroenterol. 2004;99:582–588.

    Article  PubMed  Google Scholar 

  3. Cook MB, Wild CP, Forman D. A systematic review and meta-analysis of the sex ratio for Barrett’s esophagus, erosive reflux disease, and nonerosive reflux disease. Am J Epidemiol. 2005;162:1050–1061.

    Article  PubMed  CAS  Google Scholar 

  4. Shaheen NJ. Advances in Barrett’s esophagus and esophageal adenocarcinoma. Gastroenterology. 2005;128:1554–1566.

    Article  PubMed  Google Scholar 

  5. Conio M, Blanchi S, Lapertosa G, et al. Long-term endoscopic surveillance of patients with Barrett’s esophagus: incidence of dysplasia and adenocarcinoma—a prospective study. Am J Gastroenterol. 2003;98:1931–1939.

    Article  PubMed  Google Scholar 

  6. Ronkainen J, Aro P, Storskrubb T, et al. Prevalence of Barrett’s esophagus in the general population: an endoscopic study. Gastroenterology. 2005;129:1825–1831.

    Article  PubMed  Google Scholar 

  7. Wong A, Fitzgerald RC. Epidemiologic risk factors for Barrett’s esophagus and associated adenocarcinoma. Clin Gastroenterol Hepatol. 2005;3:1–10.

    Article  PubMed  CAS  Google Scholar 

  8. Lieberman D, Fennerty MB, Morris CD, et al. Endoscopic evaluation of patients with dyspepsia: results from the national endoscopic data repository. Gastroenterology. 2004;127:1067–1075.

    Article  PubMed  Google Scholar 

  9. Chalasani N, Wo JM, Hunter JG, et al. Significance of intestinal metaplasia in different areas of esophagus including esophagogastric junction. Dig Dis Sci. 1997;43:603–607.

    Article  Google Scholar 

  10. Spechler SJ, Jain SK, Tendler DA, et al. Racial differences in the frequency of symptoms and complications of gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 2002;16:1795–1800.

    Article  PubMed  CAS  Google Scholar 

  11. Fisher D, Jeffreys A, Bosworth H, et al. Quality of life in patients with Barrett’s esophagus undergoing surveillance. Am J Gastroenterol. 2002;97:2193–2200.

    Article  PubMed  Google Scholar 

  12. Weston AP, Sharma P, Mathur S, et al. Risk stratification of Barrett’s esophagus: updated prospective multivariate analysis. Am J Gastroenterol. 2004;99:1657–1666.

    Article  PubMed  Google Scholar 

  13. Sharma P, Falk GW, Weston AP, et al. Dysplasia and cancer in a large multicenter cohort of patients with Barrett’s esophagus. Clin Gastroenterol Hepatol. 2006;4:566–572.

    Article  PubMed  Google Scholar 

  14. Abrams JA, Fields S, Lightdale CJ, et al. Racial and ethnic disparities in the prevalence of Barrett’s esophagus among patients who undergo upper endoscopy. Clin Gastroenterol Hepatol. 2008;6:30–34.

    Article  PubMed  Google Scholar 

  15. Fan X, Snyder N. Prevalence of Barrett’s esophagus in patients with or without GERD symptoms: role of race age and gender. Dig Dis Sci. 2009;54:572–577.

    Article  PubMed  Google Scholar 

  16. Wang A, Mattek NC, Holub JL, et al. Prevalence of complicated gastroesophageal reflux disease and Barrett’s esophagus among racial groups in a multicenter consortium. Dig Dis Sci. 2009;54:964–971.

    Article  PubMed  Google Scholar 

  17. El-Serag HB, Petersen NJ, Carter J, et al. Gastroesophageal reflux among different racial groups in the United States. Gastroenterology. 2004;124:1692–1699.

    Article  Google Scholar 

  18. Moreno Elola-Olaso C, Rey E, Rodriguez-Artalejo F, et al. Adaptation and validation of a gastroesophageal reflux questionnaire for use in a Spanish population. Rev Esp Enferm Dig. 2002;94:752–758.

    Google Scholar 

  19. Johnson RL, Roter D, Powe NR, et al. Patient race/ethnicity and quality of patient–physician communication during medical visits. Am J Public Health. 2004;94:2084–2090.

    Article  PubMed  Google Scholar 

  20. Vega KJ, Chisholm S, Jamal MM. Comparison of reflux esophagitis and its complications between African Americans and non-Hispanic whites. World J Gastroenterol. 2009;15:2878–2881.

    Article  PubMed  Google Scholar 

  21. Weston AP, Badr AS, Topalovski M, et al. Prospective evaluation of the prevalence of gastric Helicobacter pylori infection in patients with GERD, Barrett’s esophagus, Barrett’s dysplasia, and Barrett’s adenocarcinoma. Am J Gastroenterol. 2000;95:387–394.

    Article  PubMed  CAS  Google Scholar 

  22. Vicari JJ, Peek RM, Falk GW, et al. The seroprevalence of cagA-positive Helicobacter pylori strains in the spectrum of gastroesophageal reflux disease. Gastroenterology. 1998;115:50–57.

    Article  PubMed  CAS  Google Scholar 

  23. Malaty HM, Evans DG, Evans DJ Jr, et al. Helicobacter pylori in Hispanics: comparison with blacks and whites of similar age and socioeconomic class. Gastroenterology. 1992;103:813–816.

    PubMed  CAS  Google Scholar 

  24. Galdas PM, Cheater F, Marshall P. Men and health help-seeking behavior: literature review. J Adv Nurs. 2005;49:616–623.

    Article  PubMed  Google Scholar 

  25. Cheatham CT, Barksdale DJ, Rogers SG. Barriers to health care and health-seeking behaviors faced by Black men. J Am Acad Nurse Pract. 2008;20:555–562.

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

No conflict of interest exists for all authors in this manuscript.

Author information

Authors and Affiliations

  1. Division of Gastroenterology, University of Florida/Jacksonville, Jacksonville, FL, USA

    Joe E. Khoury, Sunitha Pudhota & Kenneth J. Vega

  2. Department of Medicine, University of Florida/Jacksonville, Jacksonville, FL, USA

    Sian Chisholm & Carlos Palacio

  3. Division of Gastroenterology, VAMC, Long Beach, CA, USA

    M. Mazen Jamal

  4. University of California, Irvine, CA, USA

    M. Mazen Jamal

  5. Division of Digestive Diseases and Nutrition, University of Oklahoma Health Sciences Center, 920 Stanton L. Young Boulevard, WP 1345, Oklahoma City, OK, 73104, USA

    Kenneth J. Vega

Authors
  1. Joe E. Khoury
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sian Chisholm
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Mazen Jamal
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Carlos Palacio
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sunitha Pudhota
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kenneth J. Vega
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kenneth J. Vega.

Additional information

This research was approved by the University of Florida College of Medicine/Jacksonville institutional review board.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Khoury, J.E., Chisholm, S., Mazen Jamal, M. et al. African Americans with Barrett’s Esophagus Are Less Likely to Have Dysplasia at Biopsy. Dig Dis Sci 57, 419–423 (2012). https://doi.org/10.1007/s10620-011-1900-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-011-1900-y

Keywords

Search

Navigation