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Prevalence of Complicated Gastroesophageal Reflux Disease and Barrett’s Esophagus Among Racial Groups in a Multi-Center Consortium

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Abstract

Aims The Clinical Outcomes Research Initiative database was used to evaluate ethnic trends in complicated reflux disease and suspected Barrett’s esophagus among various racial groups. Methods Endoscopic findings for procedures performed January 2000–December 2005 for any indication and for reflux-related indications were reviewed by racial group. Results Of 280,075 procedures examined, Hispanics were the most likely to have esophagitis (Hispanic 19.6%, white 17.3%, black 15.8%, Asian/Pacific Islander 9.5%, P-value < 0.0001), and white subjects were most likely to have suspected BE (white 5.0%, Hispanic 2.9%, Asian/Pacific Islander 1.8%, black 1.5%, P-value < 0.0001). Endoscopies performed for reflux-related indications had similar trends for esophagitis and esophageal stricture. Among reflux/Barrett’s screening procedures adjusted for age and gender, Hispanics were most likely to have esophagitis (OR = 1.28, P-value < 0.0001) compared to Caucasians. Conclusion Our results demonstrate an association of suspected Barrett’s esophagus and stricture with white patients and esophagitis with Hispanic patients. These findings need to be followed-up with further study.

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Abbreviations

API:

Asian/Pacific Islander

ACG:

American College of Gastroenterology

BE:

Barrett’s esophagus

BNH:

Black non-Hispanic

CMS:

Centers for Medicare and Medicaid Service

CORI:

Clinical Outcomes Research Initiative

GERD:

Gastroesophageal reflux disease

LA:

Los Angeles

LSBE:

Long-segment Barrett’s esophagus

NED:

National Endoscopic Database

NNE:

Number needed to endoscope

PPI:

Proton pump inhibitors

SSBE:

Short-segment Barrett’s esophagus

VA:

Veteran’s Affairs

WNH:

White non-Hispanic

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Acknowledgments

This project was supported with funding from NIDDK UO1 CA 89389-01 and R33-DK61778-01. In addition, the practice network (CORI) has received support from the following entities to support the infrastructure of the practice-based network: AstraZeneca, Bard International, Pentax USA, ProVation, Endosoft, GIVEN Imaging, and Ethicon. The commercial entities had no involvement in this research. DL is the executive director of CORI and GE is the executive co-director of CORI, a nonprofit organization that receives funding from federal and industry sources. This potential conflict of interest has been reviewed and managed by the Oregon Health and Science University (OHSU) Conflict of Interest in Research Committee. This research was conducted with support from the Investigator-Sponsored Study Program of AstraZeneca.

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Correspondence to Amy Wang.

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Wang, A., Mattek, N.C., Holub, J.L. et al. Prevalence of Complicated Gastroesophageal Reflux Disease and Barrett’s Esophagus Among Racial Groups in a Multi-Center Consortium. Dig Dis Sci 54, 964–971 (2009). https://doi.org/10.1007/s10620-009-0742-3

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  • DOI: https://doi.org/10.1007/s10620-009-0742-3

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