UK acid-related disease trends revealed

By Lynda Williams, Senior medwireNews Reporter

The incidence of Barrett's esophagus (BE) in the UK has doubled in recent years, but the incidence of gastroesophageal reflux disease (GERD) is stable, study findings reveal.

The research used information collated from the General Practice Research Database for 5860 patients with BE and 125,519 patients with GERD to demonstrate changes in the care and incidence of acid-related disease in the UK between 1996 and 2005.

Kalliopi Alexandropoulou and co-authors, from St George's Hospital and Medical School in London, UK, say their research "provides a reliable reflection of the burden of these diseases currently in the UK and a baseline for future studies to compare trends in disease epidemiology as management changes are implemented."

As reported in the European Journal of Gastroenterology and Hepatology, the incidence of BE increased from 0.11 to 0.24 cases per 1000 men and from 0.06 to 0.11 cases per 1000 women over the period.

While the results may represent a "genuine increase" in BE incidence, the researchers note that the findings may also reflect increased use of endoscopy over the study period, and changes in the definition of BE to include short segment disease.

By contrast, the rate of GERD was stable, at an average incidence of 3.99 cases per 1000 men and 4.55 cases per 1000 women.

Esophageal cancer was reported in 69 patients with BE and 183 patients with a diagnosis of GERD at least a year before cancer detection. The accumulated incidence of esophageal cancer was 3.00 cases per 1000 BE patient-years compared with just 0.30 cases per 1000 GERD patient-years.

Alexandropoulou et al note that the study period "witnessed huge changes in the management of acid-related conditions." This, they say, is demonstrated by a decrease in histamine-2 receptor antagonist prescriptions, from 39.0 to 14.5% of patients with a new diagnosis of GERD, and an increase in proton pump inhibitor use from 52% to 79%.

"These trends have significant implications for healthcare planning and financing in the UK and other countries," the team concludes.

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