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Barrett's Esophagus and Esophageal Adenocarcinoma in South Carolina in 2003

Geographic Analysis of Prevalence and Effect of Availabitiy of a Gastroenterologist

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DeVicente, Noah M., M.D.; Vela, Marcelo F., M.D.

American Journal of Gastroenterology: September 2005 - Volume 100 - Issue - p S45–S46
Supplement Abstracts Submitted for the 70th Annual Scientific Meeting of the American College of Gastroenterology: ESOPHAGUS
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Gastroenterology and Hepatology, Medical University of South Carolina, Charleston, SC.

Purpose: The incidence of Esophageal Adenocarcinoma (EA) is rapidly rising. Diagnosing Barrett's Esophagus (BE), a precursor of EA, is important because it enables surveillance and detection of malignancy at a curable stage. Geographic analyses of BE and EA prevalence that consider the effect of gastroenterologist availability are lacking. Our aim was to asses geographic variation in 2003 BE and EA prevalence across South Carolina (SC) counties, examine effect of GI availability and compare gender/ethnic variation to published data.

Methods: 2003 number of BE cases (ICD-9 search), number of gastroenterologists, and population demographics for each county from SC Office of Statistics. 2003 number of EA cases per county from SC Cancer Registry. Geographic distribution and relationships among BE/EA prevalence and GIs (no. doctors/100,000 population) studied by Geographic Information System for Epidemiological Studies (ArcView 3.x).

Results: SC 2003 prevalence: 98.9/100,000 for BE (M;F ratio 1.5:1, white:nonwhite ratio 2.3:1); 3.5/100,000 for EA (M;F ratio 4.7:1, white:nonwhite ratio 2.1:1). GIS analysis: BE prevalence higher in counties with high number of Gis (map not shown); highest EA prevalence seen in counties with limited or no access to GI (see map).

Conclusions: Availability of a GI may impact BE diagnosis/prevalence in different SC geographic areas. Rates appear higher for females compared to literature. Undetected BE in regions with limited access to GI may lead to higher EA prevalence. If supported by further studies, these data can be used to determine need of GIs and endoscopic centers in specific geographic areas. Five-year data analysis in progress.[figure 1]

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