BACKGROUND: Both the demographics underlying the sex ratio in the prevalence of Barrett's esophagus (BE) and the status of BE without intestinal metaplasia (IM) are unclear. AIMS: To establish the demographics of histologically proven BE, IM+ and IM-, over a 15-yr period from a primary referral, endoscopy unit. PATIENTS: For all BE patients aged 20-89 yr, identified between 1982 and 1996, IM+ or IM-, AND METHODS: prevalences were calculated per 100 first endoscopies. RESULTS: A total of 492 cases of BE, 320 (248 IM+) in males, 175 (127 IM+) in females were identified in 21,899 first endoscopies (10,939 males, 10,960 females). Between ages 20 and 59 yr in males and 20-79 in females, IM+, IM- and all BE prevalences rose by ±7.36% for each additional year of age (p = 0.92) with, however, a 20-yr age shift between the sexes, resulting in a male:female OR 4.15 95% Cl 2.99-5.77. A declining rate of increase in over 59 males resulted in an overall male:female OR 2.14, 95% Cl 1.77-2.58. Over the age of 79 yr, BE prevalences/100 first endoscopies fell from a maximum of 5.1 in males and 3.65 in females to 3.38 and 2.53, respectively. CONCLUSION: The 4:1 sex ratio and 20-yr age shift between males and females in the prevalence of BE, both IM+ and IM-, found in younger age groups, was the main cause of the overall BE 2:1 sex ratio. The very similar demographics of IM- and IM+ BE suggest they may be two consecutive stages in the same metaplastic process.,
American Journal of Gastroenterology
Erasmus MC: University Medical Center Rotterdam

van Blankenstein, M., Looman, C., Johnston, B., & Caygill, C. (2005). Age and sex distribution of the prevalence of Barrett's esophagus found in a primary referral endoscopy center. American Journal of Gastroenterology, 100(3), 568–576. doi:10.1111/j.1572-0241.2005.40187.x