The Prevalence of Barrett's-esophagus-associated Dysplasia in Puerto Rico.

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.