P0422 - Barrett’s Esophagus Endoscopic Prevalence in a Majority African-American/Hispanic Population

Kesiena Akpoigbe, MD¹, Joan Culpepper-Morgan, MD, FACG², Angela Barnes, MD³, Kenneth J. Vega, MD, FACG^3
1Harlem Hospital Center, New York, NY; ²Harlem Hospital, New York, NY; ³Medical College of Georgia at Augusta University, Augusta, GA

Introduction: Barrett’s esophagus (BE) is a premalignant lesion of the esophagus with an estimated United States (US) prevalence of 5.6%. It is more common in the White population and associated with a 0.5% yearly risk of progression to esophageal adenocarcinoma. Previous studies have estimated the prevalence of BE in African Americans (AA) and Hispanics to be low with the odds of developing BE in AA to be 0.34 and for Hispanics 0.38. However, there is no data on BE endoscopic prevalence at an institution that serves a majority AA/Hispanics community.

Methods: We performed a retrospective cross-sectional study of Harlem Hospital patients who had undergone esophagogastroduodenoscopy (EGD) and biopsy from January 2018 to January 2022 for any indication to determine the endoscopic prevalence of BE in our predominantly AA (65%) and Hispanic (30%) population. Histological confirmation of a diagnosis of BE as well as presence of dysplasia or carcinoma was extracted from the pathology reports. Long segment BE (LSBE) was defined as segment greater than 3cm. Demographic variables recorded for each patient including age, sex, race, and ethnicity. Risk factors for BE including PPI use, H. pylori infection, smoking, and alcohol use were recorded from the medical record.

Results: Of the 3012 patient who had EGD for any indication, 49.7% were AA, 48.5% Hispanic, 0.9% White. Esophageal biopsy of 888 patients revealed only 18 with salmon colored mucosa suspicious for BE. Eight of the samples had BE confirmed. Three AA males, two AA females, two Hispanic females, and one White male. The overall prevalence of BE was 0.2% (8/3012). Significantly lower prevalence was observed amongst African-Americans [0.3% (5/1496)] and Hispanics [0.1% (2/1462)] compared to Whites [3.3% (1/30)] (p< 0.05). Four patients had dysplasia. Low grade dysplasia was found in one AA male, one AA female, and one Hispanic female. The lone subject with high grade dysplasia which later became malignant was an AA male. (Table 1)

Discussion: Our study did not confirm male predominance or obesity in the prevalence of BE, suggesting different pathogenesis. The vast majority of our subjects were on PPIs or had esophagitis on biopsy. The prevalence of BE in our population of majority AAs and Hispanics was low. The differences between race/ethnicities was significant. These findings are consistent with previous literature. However, this is the first study to assess BE endoscopic prevalence in a majority non-White setting.



Disclosures:


Kesiena Akpoigbe, MD¹, Joan Culpepper-Morgan, MD, FACG², Angela Barnes, MD³, Kenneth J. Vega, MD, FACG³. P0422 - Barrett’s Esophagus Endoscopic Prevalence in a Majority African-American/Hispanic Population, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.