American Journal of Epidemiology Advance Access originally published online on August 2, 2005
American Journal of Epidemiology 2005 162(5):454-460; doi:10.1093/aje/kwi218
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ORIGINAL CONTRIBUTIONS |
Ethnicity, Gender, and Socioeconomic Status as Risk Factors for Esophagitis and Barrett's Esophagus
1 Centre for Digestive Diseases, Leeds General Infirmary, Leeds, United Kingdom
2 Centre for Epidemiology and Biostatistics, Leeds University Medical School, Leeds, United Kingdom
3 Bradford Royal Infirmary, Bradford, United Kingdom
4 Gastroenterology Unit, City Hospital, Birmingham, United Kingdom
5 Division of Gastroenterology, Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
Correspondence to Dr. Alexander C. Ford, Centre for Digestive Diseases, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, United Kingdom (e-mail: alexf12399{at}yahoo.com).
Barrett's esophagus is thought to be a disease occurring predominantly in White Caucasian males of higher socioeconomic status. There are no published studies simultaneously examining risk of Barrett's esophagus according to ethnicity, gender, and socioeconomic status within a single data set. The authors conducted a retrospective case-control analysis within a cross-sectional study to determine risk of Barrett's esophagus in relation to sociodemographic variables in a large United Kingdom population. All patients undergoing upper gastrointestinal endoscopy at two clinical centers between January 2000 and January 2003 were evaluated. Data on ethnicity, age, gender, socioeconomic status, and the presence of Barrett's esophagus and esophagitis at endoscopy were collected. A total of 20,310 patients were analyzed. Barrett's esophagus was more common in White Caucasians (401/14,095 (2.8%)) than in South Asians (16/5,190 (0.3%)) (adjusted odds ratio (OR) = 6.03, 95% confidence interval (CI): 3.56, 10.22), as was esophagitis (2,500/14,095 (17.7%) vs. 557/5,190 (10.7%); adjusted OR = 1.76, 95% CI: 1.57, 1.97). Patients with Barrett's esophagus were also more likely to be male (adjusted OR = 2.70, 95% CI: 2.18, 3.35) and of higher socioeconomic status (adjusted OR = 1.58, 95% CI: 1.16, 2.15 (top tertile vs. bottom tertile)). White Caucasian ethnicity, male gender, and higher socioeconomic status are independent risk factors for Barrett's esophagus.
Barrett esophagus; esophagitis; ethnicity; social class
Abbreviations: CI, confidence interval; OR, odds ratio
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