Prevalence of Barrett’s Esophagus and Adenocarcinoma With and Without Gastroesophageal Reflux: A Systematic Review and Meta-Analysis
Abstract
Background and Aims: While gastroesophageal reflux disease (GERD) symptoms are an essential criterion for Barrett’s esophagus (BE) screening in most gastroenterology society guidelines, a significant proportion of BE and esophageal adenocarcinoma (EAC) cases do not endorse them. In a systematic review and meta-analysis (SRM), we aimed to study the prevalence of BE/EAC in those with and without GERD. Methods: A systematic search was conducted through 5 major databases for studies reporting prevalence of BE/EAC in patients with and without GERD. Pooled proportions and odds ratios (OR) of BE, long-segment BE (LSBE), short-segment BE (SSBE), dysplasia and EAC in patients with and without GERD were synthesized. Results: Forty-three articles (12,883 patients with; 51,350 patients without GERD) were included in the final analysis. BE prevalence was 7% (95% CI 5.8–8.5) and 2.2% (1.6–3) among individuals with and without GERD, respectively. EAC prevalence was 0.6% (0.4–1) and 0.1% (0–0.2) in those with and without GERD, respectively. The overall risks for BE (OR=2.91; 2.06–4.11) and LSBE (OR=4.17; 1.78–9.77) were higher in patients with GERD, but the risk for SSBE (OR=1.77; 0.89–3.52) did not differ between the two groups. In 9 population-based high-quality studies (2244 patients with; 3724 patients without GERD), BE prevalence in patients without GERD was 4.9% (95% CI 2.6–9). BE prevalence was highest in North American studies (10.6% [GERD] and 4.8% [non-GERD]). Conclusion: BE…
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Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 51,350 participants or records.
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