Digestive Diseases and Sciences

, Volume 57, Issue 2, pp 419–423 | Cite as

African Americans with Barrett’s Esophagus Are Less Likely to Have Dysplasia at Biopsy

  • Joe E. Khoury
  • Sian Chisholm
  • M. Mazen Jamal
  • Carlos Palacio
  • Sunitha Pudhota
  • Kenneth J. Vega
Original Article



Barrett’s Esophagus (BE) is a pre-malignant condition. Limited data on BE dysplasia prevalence exists among United States ethnic groups.


The purpose of this study was to determine if the frequency of BE with dysplasia varies among the major ethnic groups presenting to our institution.


The University of Florida-Jacksonville endoscopy database was searched for all cases of endoscopic BE from September 2002 to August 2007. Histologic BE was diagnosed if salmon colored esophageal mucosa was endoscopically seen at least 1 cm above the top of the gastric folds and biopsy revealed intestinal metaplasia with Alcian blue-containing goblet cells. Demographic data collected for all included: age at diagnosis, ethnicity, sex, previous history of esophageal reflux, atypical manifestations (chronic cough, aspiration), endoscopic length of BE, presence or absence of hiatal hernia, esophageal stricture or ulcer, and presence or absence of dysplasia.


Salmon colored esophageal mucosa was observed in 405 of 7,308 patients (5.5%) and histologically confirmed in 115 of 405 patients (28%) reflecting an overall prevalence of BE of 115/7308 (1.6%) in this cohort. Ethnic distribution of histologic BE patients was as follows: 95 (83%) non-Hispanic white (nHw), 16 (14%) African American (AA) and 4 (3%) other. Long segment BE (LSBE) and any form of dysplasia was observed less frequently in AA than nHw (LSBE: 12% vs. 26% and dysplasia: 0% vs. 7%).


LSBE and dysplasia are less frequent in AA than nHw. Studies in AA with BE may illustrate factors limiting dysplasia and LSBE risk.


Barrett’s esophagus Dysplasia Demographics Ethnicity African American 


Conflict of interest

No conflict of interest exists for all authors in this manuscript.


  1. 1.
    El-Serag HB, Mason AC, Petersen N, et al. Epidemiological differences between adenocarcinoma of the oesophagus and adenocarcinoma of the gastric cardia in the USA. Gut. 2002;50:368–372.PubMedCrossRefGoogle Scholar
  2. 2.
    Kubo A, Corley DA. Marked multi-ethnic variation of esophageal and gastric cardia carcinomas within the United States. Am J Gastroenterol. 2004;99:582–588.PubMedCrossRefGoogle Scholar
  3. 3.
    Cook MB, Wild CP, Forman D. A systematic review and meta-analysis of the sex ratio for Barrett’s esophagus, erosive reflux disease, and nonerosive reflux disease. Am J Epidemiol. 2005;162:1050–1061.PubMedCrossRefGoogle Scholar
  4. 4.
    Shaheen NJ. Advances in Barrett’s esophagus and esophageal adenocarcinoma. Gastroenterology. 2005;128:1554–1566.PubMedCrossRefGoogle Scholar
  5. 5.
    Conio M, Blanchi S, Lapertosa G, et al. Long-term endoscopic surveillance of patients with Barrett’s esophagus: incidence of dysplasia and adenocarcinoma—a prospective study. Am J Gastroenterol. 2003;98:1931–1939.PubMedCrossRefGoogle Scholar
  6. 6.
    Ronkainen J, Aro P, Storskrubb T, et al. Prevalence of Barrett’s esophagus in the general population: an endoscopic study. Gastroenterology. 2005;129:1825–1831.PubMedCrossRefGoogle Scholar
  7. 7.
    Wong A, Fitzgerald RC. Epidemiologic risk factors for Barrett’s esophagus and associated adenocarcinoma. Clin Gastroenterol Hepatol. 2005;3:1–10.PubMedCrossRefGoogle Scholar
  8. 8.
    Lieberman D, Fennerty MB, Morris CD, et al. Endoscopic evaluation of patients with dyspepsia: results from the national endoscopic data repository. Gastroenterology. 2004;127:1067–1075.PubMedCrossRefGoogle Scholar
  9. 9.
    Chalasani N, Wo JM, Hunter JG, et al. Significance of intestinal metaplasia in different areas of esophagus including esophagogastric junction. Dig Dis Sci. 1997;43:603–607.CrossRefGoogle Scholar
  10. 10.
    Spechler SJ, Jain SK, Tendler DA, et al. Racial differences in the frequency of symptoms and complications of gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 2002;16:1795–1800.PubMedCrossRefGoogle Scholar
  11. 11.
    Fisher D, Jeffreys A, Bosworth H, et al. Quality of life in patients with Barrett’s esophagus undergoing surveillance. Am J Gastroenterol. 2002;97:2193–2200.PubMedCrossRefGoogle Scholar
  12. 12.
    Weston AP, Sharma P, Mathur S, et al. Risk stratification of Barrett’s esophagus: updated prospective multivariate analysis. Am J Gastroenterol. 2004;99:1657–1666.PubMedCrossRefGoogle Scholar
  13. 13.
    Sharma P, Falk GW, Weston AP, et al. Dysplasia and cancer in a large multicenter cohort of patients with Barrett’s esophagus. Clin Gastroenterol Hepatol. 2006;4:566–572.PubMedCrossRefGoogle Scholar
  14. 14.
    Abrams JA, Fields S, Lightdale CJ, et al. Racial and ethnic disparities in the prevalence of Barrett’s esophagus among patients who undergo upper endoscopy. Clin Gastroenterol Hepatol. 2008;6:30–34.PubMedCrossRefGoogle Scholar
  15. 15.
    Fan X, Snyder N. Prevalence of Barrett’s esophagus in patients with or without GERD symptoms: role of race age and gender. Dig Dis Sci. 2009;54:572–577.PubMedCrossRefGoogle Scholar
  16. 16.
    Wang A, Mattek NC, Holub JL, et al. Prevalence of complicated gastroesophageal reflux disease and Barrett’s esophagus among racial groups in a multicenter consortium. Dig Dis Sci. 2009;54:964–971.PubMedCrossRefGoogle Scholar
  17. 17.
    El-Serag HB, Petersen NJ, Carter J, et al. Gastroesophageal reflux among different racial groups in the United States. Gastroenterology. 2004;124:1692–1699.CrossRefGoogle Scholar
  18. 18.
    Moreno Elola-Olaso C, Rey E, Rodriguez-Artalejo F, et al. Adaptation and validation of a gastroesophageal reflux questionnaire for use in a Spanish population. Rev Esp Enferm Dig. 2002;94:752–758.Google Scholar
  19. 19.
    Johnson RL, Roter D, Powe NR, et al. Patient race/ethnicity and quality of patient–physician communication during medical visits. Am J Public Health. 2004;94:2084–2090.PubMedCrossRefGoogle Scholar
  20. 20.
    Vega KJ, Chisholm S, Jamal MM. Comparison of reflux esophagitis and its complications between African Americans and non-Hispanic whites. World J Gastroenterol. 2009;15:2878–2881.PubMedCrossRefGoogle Scholar
  21. 21.
    Weston AP, Badr AS, Topalovski M, et al. Prospective evaluation of the prevalence of gastric Helicobacter pylori infection in patients with GERD, Barrett’s esophagus, Barrett’s dysplasia, and Barrett’s adenocarcinoma. Am J Gastroenterol. 2000;95:387–394.PubMedCrossRefGoogle Scholar
  22. 22.
    Vicari JJ, Peek RM, Falk GW, et al. The seroprevalence of cagA-positive Helicobacter pylori strains in the spectrum of gastroesophageal reflux disease. Gastroenterology. 1998;115:50–57.PubMedCrossRefGoogle Scholar
  23. 23.
    Malaty HM, Evans DG, Evans DJ Jr, et al. Helicobacter pylori in Hispanics: comparison with blacks and whites of similar age and socioeconomic class. Gastroenterology. 1992;103:813–816.PubMedGoogle Scholar
  24. 24.
    Galdas PM, Cheater F, Marshall P. Men and health help-seeking behavior: literature review. J Adv Nurs. 2005;49:616–623.PubMedCrossRefGoogle Scholar
  25. 25.
    Cheatham CT, Barksdale DJ, Rogers SG. Barriers to health care and health-seeking behaviors faced by Black men. J Am Acad Nurse Pract. 2008;20:555–562.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Joe E. Khoury
    • 1
  • Sian Chisholm
    • 2
  • M. Mazen Jamal
    • 3
    • 4
  • Carlos Palacio
    • 2
  • Sunitha Pudhota
    • 1
  • Kenneth J. Vega
    • 1
    • 5
  1. 1.Division of GastroenterologyUniversity of Florida/JacksonvilleJacksonvilleUSA
  2. 2.Department of MedicineUniversity of Florida/JacksonvilleJacksonvilleUSA
  3. 3.Division of GastroenterologyVAMCLong BeachUSA
  4. 4.University of CaliforniaIrvineUSA
  5. 5.Division of Digestive Diseases and NutritionUniversity of Oklahoma Health Sciences CenterOklahoma CityUSA

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