The Prevalence of Barrett’s Esophagus associated Dysplasia in Puerto Rico

Abstract

Objective: Barrett’s esophagus (BE) is the strongest risk factor of esophageal adenocarcinoma (EAC). A previous study found a lower incidence of EAC in Puerto Rico (PR) as compared to other racial/ethnic groups in the United States (US). Notwithstanding, BE epidemiology in PR is unknown. Study aims: i) to determine BE prevalence among individuals with gastroenterological pathology reports from three major anatomic pathology laboratories in PR and ii) to describe the association between dysplastic BE with age and gender. Methods: Clinic-based study examined data collected from three anatomic pathology laboratories encompassing the majority of gastroenterology practices in PR. Individuals with histology confirmed BE (January 2007-December 2011) were analyzed (n=1,232). We estimated BE prevalence and adjusted odds ratios (AOR) to assess magnitude of association between dysplastic BE with age and gender using logistic regression models. Results: Overall BE prevalence was 4.4% (95% CI = 4.1–4.6). Most BE patients were males (male-to-female ratio = 2.3:1) with mean age of 64 + 13 years. Ninety one percent of BE biopsies showed no dysplasia whereas 6.2% had EAC. BE patients age > 74 years had an increased risk of EAC (AOR: 2.38, 95% CI = 1.14–4.94) compared to those < 55 years old. Males had increased EAC risk (AOR: 2.23, 95% CI = 1.23–4.06) compared to females. Conclusion: BE prevalence in PR is similar to that of non-Hispanic whites and Hispanics in US. The lower occurrence of dysplastic BE in PR could explain EAC incidence disparities between PR and other groups in the US.