High prevalence of dysplasia among women with SSc warrants screening for BE
The prevalence of Barrett’s esophagus was 12.8% among women with scleroderma, according to a study published in the American Journal of Gastroenterology.
“Women with [systemic sclerosis] with BE were significantly more likely to have absent contractility with hypotensive lower esophageal sphincter findings on [high-resolution manometry],” Diana L. Snyder, MD, from the division of gastroenterology and hepatology at Mayo Clinic, and colleagues wrote. “The high prevalence and incidence of dysplasia found suggest that women with SSc should be included in the screening recommendations for BE.”
Snyder and colleagues identified 235 women with SSc who underwent an esophagogastroduodenoscopy from 2002 to 2020. Investigators assessed demographic and high-resolution manometry (HRM) data. A total of 172 patients had HRM performed. Scleroderma was confirmed by an expert rheumatologist and an expert gastrointestinal pathologist confirmed BE diagnosis.
Women who had both SSc and BE were more likely to have scleroderma esophagus on HRM than women with just SSc (P = .018). Investigators observed historically proven BE in 30 patients with SSc. Thirteen patients had dysplasia, four patients with indefinite, seven with low grade and two with adenocarcinoma. The dysplasia incidence was 5.3% per year.
“Previous studies have found BE prevalence estimates in the female population to be much lower than in men with ratios of [men to women] ranging from [1.3:1 to 4.6:1]; therefore, the prevalence in women might be estimated below 2%,” the investigators wrote. “Our study shows a much higher BE prevalence of 12.8% in the female SSc population compared with the general female population with BE documented in the literature.”