The incidence of Barrett's oesophagus and oesophageal adenocarcinoma in the United Kingdom and The Netherlands is levelling off

Aliment Pharmacol Ther. 2014 Jun;39(11):1321-30. doi: 10.1111/apt.12759. Epub 2014 Apr 16.


Background: Barrett's oesophagus (BO) is a risk factor for oesophageal adenocarcinoma (OAC). Several studies report increasing incidences of BO with substantial variation.

Aim: To determine age- and sex-stratified incidence rates (IR) of BO and OAC.

Methods: Cohort study using two primary care databases in the United Kingdom (UK) and the Netherlands (NL) (2000-2012). BO and OAC cases were identified using disease-specific READ codes (UK) and free-text search with manual validation (NL). Age- and sex-specific incidence rates (IRs) were calculated for both BO and OAC.

Results: From the study population of 6,885,420 subjects in the UK, we identified 12,312 incident BO and 40 (0.3%) subsequent incident OAC cases. There were 1383 incident BO, and subsequent 5 (0.4%) incident OAC cases among the 1,487,191 subjects in the NL. The IR of BO increased linearly with age: 15.6/100,000 PYs (UK) and 23.7/100,000 PYs (NL) for patients aged 40-44 years, increasing to 85.6/100,000 PYs (UK) and 87.0/100,000 PYs (NL) for 70-74 years. In both the UK and the NL, IR of BO was 2-4 times higher in males than females across all age groups. With respect to calendar time, the IR of BO increased by 35% (UK) and 41% (NL) from 2000 to 2003, after which IRs remained stable until 2012.

Conclusions: The incidence rates of BO in the UK and the NL increased until 2003, but levelled off thereafter. Around 0.3% of patients with BO developed OAC at least 1 year after BO diagnosis. These findings may help tailor endoscopic surveillance strategies among patients with BO.

MeSH terms

  • Adenocarcinoma / epidemiology*
  • Adenocarcinoma / pathology
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Barrett Esophagus / epidemiology*
  • Barrett Esophagus / pathology
  • Cohort Studies
  • Databases, Factual
  • Endoscopy / methods
  • Esophageal Neoplasms / epidemiology*
  • Esophageal Neoplasms / pathology
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Netherlands / epidemiology
  • Primary Health Care
  • Retrospective Studies
  • Risk Factors
  • Sex Factors
  • Time Factors
  • United Kingdom / epidemiology

Supplementary concepts

  • Adenocarcinoma Of Esophagus