Characteristics and regional variations of patients with Barrett's oesophagus in the UK

Objectives To establish the patient characteristics and regional variation of Barrett's oesophagus in the UK in a large number (5717) of subjects. Barrett's oesophagus is a precursor lesion of oesophageal adenocarcinoma, the incidence of which is rising more rapidly than any other solid tumour. Methods Demographic data of 5717 Barrett's oesophagus patients from 27 UK centres, each registering at least 50 patients, with UK National Barrett's Oesophagus Registry, were analysed. Results Centres registering patients were distributed evenly throughout the UK. There was an excess of males, with a male to female ratio of 1.7. Mean age at diagnosis was 62.0 years for males and 67.5 years for females. In Scotland, the mean and peak age at diagnosis for males was lower than for the remainder of the UK. In contrast, there was no regional variation in mean and peak age of diagnosis for females. In 3880 Barrett's oesophagus patients with complete data, adenocarcinoma developed in 136 (3.5%). Adenocarcinoma prevalence was 4.0% in males and 2.5% in females. The male/female ratio of patients with adenocarcinoma was 3.0, twice that of Barrett's oesophagus (1.7). The mean age was 64.7 years for males and 74.0 years for females. Conclusions These data demonstrate that Barrett's oesophagus occurs with a higher frequency in males, with progression to adenocarcinoma being even more biased towards men in the UK, in contrast to the USA. There are significant regional variations in age of diagnosis of Barrett's oesophagus, especially in younger male patients in Scotland. Studies to identify genetic and environmental determinants of Barrett's oesophagus and cancer risk are needed. (C) 2003 Lippincott Williams Wilkins.