Time trends of endoscopic and pathological diagnoses related to gastroesophageal reflux disease in a Chinese population: eight years single institution experience

Authors

  • M.-J. Chen,

    1. Departments of Internal Medicine and
    2. Diagnostics & Therapeutics, College of Medicine,
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  • Y.-C. Lee,

    Corresponding author
    1. Departments of Internal Medicine and
    2. Division of Biostatistics, Graduate Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei, and
      Dr Jaw-Town Lin, MD, PhD, Department of Internal Medicine, E-Da Hospital/I-Shou University, and National Taiwan University Hospital, 7, Chung-Shan South Road, Taipei, Taiwan. Email: jawtown@ntu.edu.tw; or to Dr Yi-Chia Lee, MD, MSc, Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University. 7 Chung-Shan South Road, Taipei 100, Taiwan. Email: yichialee@ntu.edu.tw
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  • H.-M. Chiu,

    1. Departments of Internal Medicine and
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  • M.-S. Wu,

    1. Departments of Internal Medicine and
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  • H.-P. Wang,

    1. Departments of Internal Medicine and
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  • J.-T. Lin

    Corresponding author
    1. Departments of Internal Medicine and
    2. Department of Internal Medicine, E-DA Hospital and I-Shou University, Kaohsiung County, Taiwan
      Dr Jaw-Town Lin, MD, PhD, Department of Internal Medicine, E-Da Hospital/I-Shou University, and National Taiwan University Hospital, 7, Chung-Shan South Road, Taipei, Taiwan. Email: jawtown@ntu.edu.tw; or to Dr Yi-Chia Lee, MD, MSc, Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University. 7 Chung-Shan South Road, Taipei 100, Taiwan. Email: yichialee@ntu.edu.tw
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  • Financial Disclosures: None.

  • Competing Interests: There was no conflict of interest.

  • Author contributions: Mei-Jyh Chen was responsible for data collection, data analysis, and the drafting of manuscript. Han-Mo Chiu, Ming-Shiang Wu, Hsiu-Po Wang, and Jaw-Town Lin were involved in data collection, the interpretation of results on clinical implication, and the revision of manuscript. Yi-Chia Lee made contribution to study design, the interpretation of results, the drafting of manuscript, and the revision of manuscript. All authors have read and approved the paper.

Dr Jaw-Town Lin, MD, PhD, Department of Internal Medicine, E-Da Hospital/I-Shou University, and National Taiwan University Hospital, 7, Chung-Shan South Road, Taipei, Taiwan. Email: jawtown@ntu.edu.tw; or to Dr Yi-Chia Lee, MD, MSc, Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University. 7 Chung-Shan South Road, Taipei 100, Taiwan. Email: yichialee@ntu.edu.tw

SUMMARY

The discrepancy between Eastern and Western countries exists regarding the time trends of Barrett's esophagus (BE)/adenocarcinoma. We aimed to elucidate this issue through a retrospective review of the endoscopic and pathological diagnoses of gastroesophageal reflux disease (GERD) over time in a Chinese population. All records were analyzed from 2000 to 2007. Records included demographic data, clinical indication for endoscopy, and endoscopic findings. The total number of endoscopic procedures increased over time. The indications for referral endoscopy secondary to GERD increased from 366 cases (4.9%) in the beginning of the study to 1439 cases (14.1%) at the end. Concomitant GERD symptoms did not significantly change (range, 13–15.1%) in screening endoscopic studies. Endoscopic detection of erosive esophagitis increased in referral populations from 1546 (20.7%) to 5207 cases (51%) and by screening endoscopy from 791 (14.5%) to 1983 cases (23.5%). The prevalence of nonerosive reflux disease and BE did not change over time. BE-associated dysplasia and adenocarcinoma were rare. The detection of Los Angeles class A disease increased with time in referral endoscopy cases with a focus on erosive esophagitis composition. The endoscopic demand for GERD investigation and the GERD endoscopic diagnosis increased in our population. The results were related to a higher prevalence of low-grade erosive disease diagnosed. The incidence of BE-associated dysplasia and adenocarcinoma has been the same and the increased screening did not detect more cancers.

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