Protective Propensity of Race or Environmental Features in the Development of Barrett's Esophagus in African Americans – A Single Center Pilot Study

Ahmad Alkaddour, Camille McGaw, Rama Hritani, Carlos Palacio, Juan Carlos Munoz, Kenneth J Vega

Research output: Contribution to journalArticle

Abstract

Background and study aims: Barrett's Esophagus (BE) is a well-recognized pre-malignant condition. Previous data indicate histologically confirmed BE frequency varies by ethnicity in the United States. However, clinical factor assessment to explain this has only occurred in a veteran population to date. The study aim was to determine which clinical factors may be associated with the ethnic variation seen in histologically confirmed BE among a general population. Patients and methods: The University of Florida-Jacksonville endoscopy database was searched for all cases of endoscopic BE from September 2002 to October 2012. Histologic BE was diagnosed only if salmon colored, columnar-appearing esophageal mucosa was seen at endoscopy and biopsy revealed intestinal metaplasia with Alcian blue-stained goblet cells. Data collected included: age/BMI at diagnosis, ethnicity, sex, GERD history, atypical manifestations, endoscopic BE length, presence of esophageal stricture/ulcer/hiatal hernia, presence/absence of dysplasia and medication use (aspirin/NSAIDs/statin/PPI). Results: Salmon colored esophageal mucosa was observed in 1105 of 15,564 patients (7.1%) with BE histologically confirmed in 249 of 1105 patients (23%). Ethnic distribution of histologic BE patients: 83% non-Hispanic white (nHw), 13% African American (AA) and 4% other. No difference was seen between groups with regard to BMI, GERD symptom/complications, BE length, and cigarette, alcohol or medication use. Conclusion: BE occurs primarily in nHw in north Florida. This occurs despite similarities in GERD history, cigarette/alcohol use, medications prescribed and BMI. Molecular level investigation is necessary to explain this observed disparity between nHw and AA.

Original languageEnglish (US)
Pages (from-to)198-201
Number of pages4
JournalJournal of the National Medical Association
Volume111
Issue number2
DOIs
StatePublished - Apr 1 2019

Fingerprint

Barrett Esophagus
African Americans
Gastroesophageal Reflux
Salmon
Tobacco Products
Endoscopy
Alcohols
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Esophageal Stenosis
Alcian Blue
Hiatal Hernia
Goblet Cells
Metaplasia
Non-Steroidal Anti-Inflammatory Agents
Veterans
Population
Aspirin
Ulcer
Databases
Biopsy

Keywords

  • Barrett's esophagus
  • Clinical
  • Ethnicity
  • Frequency
  • Risk factors

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Protective Propensity of Race or Environmental Features in the Development of Barrett's Esophagus in African Americans – A Single Center Pilot Study. / Alkaddour, Ahmad; McGaw, Camille; Hritani, Rama; Palacio, Carlos; Munoz, Juan Carlos; Vega, Kenneth J.

In: Journal of the National Medical Association, Vol. 111, No. 2, 01.04.2019, p. 198-201.

Research output: Contribution to journalArticle

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abstract = "Background and study aims: Barrett's Esophagus (BE) is a well-recognized pre-malignant condition. Previous data indicate histologically confirmed BE frequency varies by ethnicity in the United States. However, clinical factor assessment to explain this has only occurred in a veteran population to date. The study aim was to determine which clinical factors may be associated with the ethnic variation seen in histologically confirmed BE among a general population. Patients and methods: The University of Florida-Jacksonville endoscopy database was searched for all cases of endoscopic BE from September 2002 to October 2012. Histologic BE was diagnosed only if salmon colored, columnar-appearing esophageal mucosa was seen at endoscopy and biopsy revealed intestinal metaplasia with Alcian blue-stained goblet cells. Data collected included: age/BMI at diagnosis, ethnicity, sex, GERD history, atypical manifestations, endoscopic BE length, presence of esophageal stricture/ulcer/hiatal hernia, presence/absence of dysplasia and medication use (aspirin/NSAIDs/statin/PPI). Results: Salmon colored esophageal mucosa was observed in 1105 of 15,564 patients (7.1{\%}) with BE histologically confirmed in 249 of 1105 patients (23{\%}). Ethnic distribution of histologic BE patients: 83{\%} non-Hispanic white (nHw), 13{\%} African American (AA) and 4{\%} other. No difference was seen between groups with regard to BMI, GERD symptom/complications, BE length, and cigarette, alcohol or medication use. Conclusion: BE occurs primarily in nHw in north Florida. This occurs despite similarities in GERD history, cigarette/alcohol use, medications prescribed and BMI. Molecular level investigation is necessary to explain this observed disparity between nHw and AA.",
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