| Theme | Diagnosis and Treatment of Barrett's Esophagus : up-to-date | |
|---|---|---|
| Title | Pathophysiology and Epidemiology of Barrett's Esophagus in Japan | |
| Publish Date | 2014/06 | |
| Author | Yuji Amano | Division of Endoscopy, Kaken Hospital, International University of Health and Welfare |
| Author | Takane Azumi | Division of Endoscopy, Kaken Hospital, International University of Health and Welfare |
| Author | Masaru Tsuboi | Department of Gastroenterology, Kaken Hospital, International University of Health and Welfare |
| Author | Shigeatsu Motoori | Department of Gastroenterology, Kaken Hospital, International University of Health and Welfare |
| [ Summary ] | Barrett's esophageal cancer has the fastest growing incidence of any cancer in Western countries. In Japan, most cases of esophageal cancer are squamous cell carcinomas, not adenocarcinomas. Recently, however, an increase in the number of cases of Barrett's esophagus with subsequent Barrett's adenocarcinoma has become worrisome in Japan. This is because the number of patients with gastroesophageal reflux disease is increasing. In Japan, long segment Barrett's esophagus is much less prevalent than in Western countries, while short segment Barrett's esophagus is frequently found. In epidemiological studies, evaluation of the prevalence of Barrett's esophagus is limited by low inter-observer diagnostic agreement. A standardized criteria for endoscopic diagnosis of Barrett's esophagus should be established as soon as possible. A high incidence of hiatal hernias and a decreasing prevalence of Helicobacter pylori infection may increase the number of cases with Barrett's esophagus and subsequent Barrett's adenocarcinoma in the near future. Therefore, a strategy for clinical management of Barrett's esophagus in Japanese patients should be devised. However, several differences are found in the pathophysiology and epidemiology of Barrett's esophagus in Japan compared to those in Western countries. Therefore, it is necessary to epidemiologically pursue case of Barrett's esophagus and to fully clarify much important information in Japan. | |