Prevalence and Predictors of Barrett's Esophagus After Negative Initial Endoscopy: Analysis From Two National Databases.

Autor:	Dhaliwal L; Department of Internal Medicine, Louisiana State University Health, Shreveport, Louisiana., Kamboj AK; Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota., Williams JL; GI Quality Improvement Consortium, Bethesda, Maryland., Chandar AK; Department of Internal Medicine, Case Western Reserve University Hospitals, Cleveland, Ohio., Sachdeva K; Department of Internal Medicine, Louisiana State University Health, Shreveport, Louisiana., Gibbons E; Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota., Lansing R; Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota., Passe M; Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota., Perez JA; Clinical Research Center, University Hospitals Cleveland Medical Center, Cleveland, Ohio., Avenir KLR; Clinical Research Center, University Hospitals Cleveland Medical Center, Cleveland, Ohio., Martin SA; Clinical Research Center, University Hospitals Cleveland Medical Center, Cleveland, Ohio., Leggett CL; Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota., Chak A; Division of Gastroenterology, Case Western Reserve University Hospitals, Cleveland, Ohio., Falk GW; Division of Gastroenterology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania., Wani S; Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado., Shaheen NJ; Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina., Kisiel JB; Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota., Iyer PG; Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota. Electronic address: iyer.prasad@mayo.edu.
Jazyk:	angličtina
Zdroj:	Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association [Clin Gastroenterol Hepatol] 2024 Mar; Vol. 22 (3), pp. 523-531.e3. Date of Electronic Publication: 2023 Sep 15.
DOI:	10.1016/j.cgh.2023.08.035
Abstrakt:	Background & Aims: Guidelines suggest a single screening esophagogastroduodenoscopy (EGD) in patients with multiple risk factors for Barrett's esophagus (BE). We aimed to determine BE prevalence and predictors on repeat EGD after a negative initial EGD, using 2 large national databases (GI Quality Improvement Consortium [GIQuIC] and TriNetX). Methods: Patients who underwent at least 2 EGDs were included and those with BE or esophageal adenocarcinoma detected at initial EGD were excluded. Patient demographics and prevalence of BE on repeat EGD were collected. Multivariate logistic regression was performed to assess for independent risk factors for BE detected on the repeat EGD. Results: In 214,318 and 153,445 patients undergoing at least 2 EGDs over a median follow-up of 28-35 months, the prevalence of BE on repeat EGD was 1.7% in GIQuIC and 3.4% in TriNetX, respectively (26%-45% of baseline BE prevalence). Most (89%) patients had nondysplastic BE. The prevalence of BE remained stable over time (from 1 to >5 years from negative initial EGD) but increased with increasing number of risk factors. BE prevalence in a high-risk population (gastroesophageal reflux disease plus ≥1 risk factor for BE) was 3%-4%. Conclusions: In this study of >350,000 patients, rates of BE on repeat EGD ranged from 1.7%-3.4%, and were higher in those with multiple risk factors. Most were likely missed at initial evaluation, underscoring the importance of a high-quality initial endoscopic examination. Although routine repeat endoscopic BE screening after a negative initial examination is not recommended, repeat screening may be considered in carefully selected patients with gastroesophageal reflux disease and ≥2 risk factors for BE, potentially using nonendoscopic tools. (Copyright © 2024 AGA Institute. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu