Copyright
©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
Gender disparities and woman-specific trends in Barrett’s esophagus in the United States: An 11-year nationwide population-based study
Karina Fatakhova, Faisal Inayat, Hassam Ali, Pratik Patel, Attiq Ur Rehman, Arslan Afzal, Muhammad Sarfraz, Shiza Sarfraz, Gul Nawaz, Ahtshamullah Chaudhry, Rubaid Dhillon, Arthur Dilibe, Benjamin Glazebnik, Lindsey Jones, Emily Glazer
Karina Fatakhova, Pratik Patel, Emily Glazer, Division of Gastroenterology and Hepatology, Mather Hospital and Zucker School of Medicine at Hofstra University, Port Jefferson, NY 11777, United States
Faisal Inayat, Gul Nawaz, Department of Internal Medicine, Allama Iqbal Medical College, Lahore, Punjab 54550, Pakistan
Hassam Ali, Arslan Afzal, Division of Gastroenterology and Hepatology, East Carolina University Brody School of Medicine, Greenville, NC 27834, United States
Attiq Ur Rehman, Muhammad Sarfraz, Division of Gastroenterology and Hepatology, Geisinger Wyoming Valley Medical Center, Wilkes-Barre, PA 18711, United States
Shiza Sarfraz, Arthur Dilibe, Department of Internal Medicine, East Carolina University Brody School of Medicine, Greenville, NC 27834, United States
Ahtshamullah Chaudhry, Department of Internal Medicine, St. Dominic's Hospital, Jackson, MS 39216, United States
Rubaid Dhillon, Department of Gastroenterology, Hepatology, and Nutrition, Cleveland Clinic Foundation, Cleveland, OH 44195, United States
Benjamin Glazebnik, Lindsey Jones, Department of Internal Medicine, Mather Hospital and Hofstra University Zucker, School of Medicine, Port Jefferson, NY 11777, United States
Author contributions: Fatakhova K, Inayat F, Ali H, Patel P, Rehman AU, Afzal A, and Sarfraz M concepted and designed the study, participated in the acquisition of data, interpretation of results, writing of the original draft, and critical revisions of the important intellectual content of the final manuscript; Sarfraz S, Nawaz G, Chaudhry A, Dhillon R, Dilibe A, Glazebnik B, and Jones L contributed to the analysis and interpretation of results and drafting of the manuscript; Glazer E reviewed, revised, and improved the manuscript by suggesting pertinent modifications; and all authors critically assessed, edited, and approved the final manuscript and are accountable for all aspects of the work.
Institutional review board statement: The data of patients was not acquired by any specific institution but rather open-access United States National Inpatient Sample (NIS) data. The NIS contains de-identified information, protecting the privacy of patients, physicians, and hospitals. Therefore, it was deemed exempt from the institutional review board (IRB).
Informed consent statement: Participants were not required to give informed consent for this retrospective study since the analysis of baseline characteristics used anonymized clinical data.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Faisal Inayat, MBBS, Research Scientist, Department of Internal Medicine, Allama Iqbal Medical College, Allama Shabbir Ahmad Usmani Road, Faisal Town, Lahore, Punjab 54550, Pakistan.
faisalinayat@hotmail.com
Received: May 31, 2024
Revised: July 25, 2024
Accepted: July 29, 2024
Published online: March 20, 2025
Processing time: 120 Days and 8.2 Hours
BACKGROUND
Barrett's esophagus (BE) is a known premalignant precursor to esophageal adenocarcinoma (EAC). The prevalence rates continue to rise in the United States, but many patients who are at risk of EAC are not screened. Current practice guidelines include male gender as a predisposing factor for BE and EAC. The population-based clinical evidence regarding female gender remains limited.
AIM
To study comparative trends of gender disparities in patients with BE in the United States.
METHODS
A nationwide retrospective study was conducted using the 2009-2019 National Inpatient Sample (NIS) database. Patients with a primary or secondary diagnosis code of BE were identified. The major outcome of interest was determining the gender disparities in patients with BE. Trend analysis for respective outcomes for females was also reported to ascertain any time-based shifts.
RESULTS
We identified 1204190 patients with BE for the study period. Among the included patients, 717439 (59.6%) were men and 486751 (40.4%) were women. The mean age was higher in women than in men (67.1 ± 0.4 vs 66.6 ± 0.3 years, P < 0.001). The rate of BE per 100000 total NIS hospitalizations for males increased from 144.6 in 2009 to 213.4 in 2019 (P < 0.001). The rate for females increased from 96.8 in 2009 to 148.7 in 2019 (P < 0.001). There was a higher frequency of obesity among women compared to men (17.4% vs 12.6%, P < 0.001). Obesity prevalence among females increased from 12.3% in 2009 to 21.9% in 2019 (P < 0.001). A lower prevalence of smoking was noted in women than in men (20.8% vs 35.7%, P < 0.001). However, trend analysis showed an increasing prevalence of smoking among women, from 12.9% in 2009 to 30.7% in 2019 (P < 0.001). Additionally, there was a lower prevalence of alcohol abuse, Helicobacter pylori (H. pylori), and diabetes mellitus among females than males (P < 0.001). Trend analysis showed an increasing prevalence of alcohol use disorder and a decreasing prevalence of H. pylori and diabetes mellitus among women (P < 0.001).
CONCLUSION
The prevalence of BE among women has steadily increased from 2009 to 2019. The existing knowledge concerning BE development has historically focused on men, but our findings show that the risk in women is not insignificant.
Core Tip: Currently, large epidemiologic data evaluating the gender-based differences in Barrett’s esophagus (BE) remain limited. Using the 2009-2019 National Inpatient Sample database, we conducted this retrospective study to assess the gender disparities and trends in patients with BE. According to our data, the prevalence of BE in women increased steadily during the course of the study. Trend analysis among females revealed an increasing prevalence of obesity, smoking, and alcohol abuse and a declining prevalence of Helicobacter pylori and diabetes. These observations indicate that the risk of BE in women is not insignificant. Further research is required to carefully screen for risk factors and determine the underlying mechanisms of BE and esophageal adenocarcinoma in female patients.
