Increased Prevalence of Barrett's Esophagus in Taiwan

Background and Aim: With rising rates of esophageal adenocarcinoma (EAC) in Western countries, Barrett's esophagus (BE) has become a growing concern. The increasing prevalence of chronic gastroesophageal reflux disease (GERD) in Taiwan suggests a potential rise in BE cases as well. A 2007 large-scale study reported a BE prevalence of 1.06% in Taiwan. Our multicenter prospective study aims to evaluate the current prevalence of BE and identify key risk factors in this region. Method: We assessed outpatients undergoing upper gastrointestinal endoscopy for various symptoms, obtaining biopsies from endoscopically suspected esophageal metaplasia (ESEM) at least 1 cm above the gastroesophageal junction. Quadrant biopsies were taken every 2 cm, with BE confirmed by histological evidence of specialized intestinal metaplasia. Results: Among 8697 subjects, the prevalence of BE was 2.6%. GERD symptoms, erosive esophagitis (EE), and hiatal hernia (HH) were present in 52.5%, 27.3%, and 7.85% of subjects, respectively. Of 751 with ESEM, 228 were diagnosed with BE, predominantly short-segment BE (78.1%). Multivariate analysis identified significant risk factors for BE: age > 50 (OR = 1.59), male gender (OR = 2.27), alcohol consumption (OR = 1.70), GERD symptoms (OR = 1.45), EE (OR = 1.94), and HH (OR = 2.49) (all p < 0.01). Conclusion: The prevalence of BE was identified as 2.6%, representing a significant increase compared with 2007. Significant risk factors include age more than 50, male gender, alcohol use, GERD symptoms, EE, and HH.