Current status of Barrett's esophagus research in Asia
Article first published online: 25 JAN 2011
© 2011 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd
Journal of Gastroenterology and Hepatology
Volume 26, Issue 2, pages 240–246, February 2011
How to Cite
Chang, C.-Y., Cook, M. B., Lee, Y.-C., Lin, J.-T., Ando, T., Bhatia, S., Chow, W.-H., El-Omar, E. M., Goto, H., Li, Y.-Q., McColl, K., Reddy, N., Rhee, P.-L., Sharma, P., Sung, J. J.-Y., Ghoshal, U., Wong, J. Y.-Y., Wu, J. C.-Y., Zhang, J., Ho, K.-Y. and the Asian Barrett's Consortium (2011), Current status of Barrett's esophagus research in Asia. Journal of Gastroenterology and Hepatology, 26: 240–246. doi: 10.1111/j.1440-1746.2010.06529.x
- Issue published online: 25 JAN 2011
- Article first published online: 25 JAN 2011
- Accepted manuscript online: 18 OCT 2010 07:10AM EST
- Accepted for publication 22 September 2010.
- Barrett's esophagus;
- esophageal adenocarcinoma;
- gastroesophageal reflux disease;
- risk factor
In Western countries, the epidemiology of esophageal cancer has changed considerably over the past decades with a rise in the ratio of adenocarcinoma to squamous cell carcinoma. Although the prevalence of gastroesophageal reflux is increasing in Asia, the prevalences of Barrett's esophagus (BE) and esophageal adenocarcinoma (EAC) have remained low in most Asian countries. The Asian Barrett's Consortium recently conducted a review of published studies on BE from Asia to assess the current status of BE research in Asia, and to recommend potential areas for future BE research in the region. Differences in study design, enrolled population, and endoscopic biopsy protocols used have led to substantial variability in the reported BE prevalence (0.06% to 19.9%) across Asia. In particular, some Japanese studies used diagnostic criteria that differed considerably from what was used in most Asian studies. As in Western countries, increased age, male sex, tobacco smoking, reflux symptoms, and erosive esophagitis have been found to be risk factors for BE in several case-control studies from Asia. The Prague C and M criteria, developed to provide better interobserver reliability in diagnosis and grading of BE, are currently under extensive evaluation in the Asian population. There is a need for standardized protocols for endoscopic and histopathologic diagnosis before initiating collaborative projects to identify etiologic determinants of BE and its ensuing malignant transformation. At present, data regarding the management and long-term outcome of BE are extremely limited in Asia. More studies of BE in this geographic area are warranted.