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

BackgroundBarrett's oesophagus (BO) is a risk factor for oesophageal adenocarcinoma (OAC). Several studies report increasing incidences of BO with substantial variation. AimTo determine age- and sex-stratified incidence rates (IR) of BO and OAC. MethodsCohort 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. ResultsFrom the study population of 6885420 subjects in the UK, we identified 12312 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 1487191 subjects in the NL. The IR of BO increased linearly with age: 15.6/100000 PYs (UK) and 23.7/100000 PYs (NL) for patients aged 40-44years, increasing to 85.6/100000 PYs (UK) and 87.0/100000 PYs (NL) for 70-74years. 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. ConclusionsThe 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 1year after BO diagnosis. These findings may help tailor endoscopic surveillance strategies among patients with BO.