Prevalence of upper gastrointestinal endoscopic findings in the community: A systematic review of studies in unselected samples of subjects

• Published in: Journal of gastroenterology and hepatology Vol. 31; no. 9; pp. 1527 - 1538
• Main Authors: Zagari, Rocco Maurizio, Eusebi, Leonardo Henry, Rabitti, Stefano, Cristoferi, Laura, Vestito, Amanda, Pagano, Nico, Bazzoli, Franco
• Format: Journal Article
• Language: English
• Published: Australia Blackwell Publishing Ltd 01.09.2016
• Subjects: Barrett Esophagus - diagnosis; Barrett Esophagus - epidemiology; Barrett Esophagus - microbiology; Endoscopy, Gastrointestinal - methods; epidemiology; Gastroesophageal Reflux - diagnosis; Gastroesophageal Reflux - epidemiology; Gastroesophageal Reflux - microbiology; Gastrointestinal Diseases - diagnosis; Gastrointestinal Diseases - epidemiology; Gastrointestinal Diseases - microbiology; Helicobacter Infections - complications; Helicobacter Infections - diagnosis; Helicobacter Infections - epidemiology; Helicobacter pylori; Humans; Peptic Ulcer - diagnosis; Peptic Ulcer - epidemiology; Peptic Ulcer - microbiology; Prevalence; Stomach Neoplasms - diagnosis; Stomach Neoplasms - epidemiology; Stomach Neoplasms - microbiology; upper gastrointestinal endoscopic findings; Helicobacter pylori; epidemiology; upper gastrointestinal endoscopic findings
• ISSN: 0815-9319; 1440-1746
• DOI: 10.1111/jgh.13308

Background and Aim Upper gastrointestinal endoscopic findings, such as esophagitis, Barrett's esophagus, peptic ulcer, and malignancy, represent a public health problem. This systematic review aimed to evaluate the prevalence of upper gastrointestinal endoscopic findings in the community. Methods A systematic search was conducted in PUBMED and EMBASE to May 2015. Studies were eligible if they reported the prevalence of upper gastrointestinal endoscopic findings in unselected samples of the community. Results Twelve articles were eligible, nine reported data from three endoscopic surveys (n = 3063 subjects), and three from national screening programs (n = 84 153). The overall prevalence of upper gastrointestinal endoscopic findings in the community was 30% in the Kalixanda study (Sweden), 24.9% in the Loiano–Monghidoro study (Italy), and 68.9% in the Systematic Investigation of Gastrointestinal Diseases study (China). The pooled prevalence of esophagitis, endoscopically suspected esophageal metaplasia (ESEM), peptic ulcer, and gastric cancer in all studies was 11.2, 5.1, 6.8, and 0.33%, respectively. The most frequent finding was esophagitis in Europe, with a prevalence of 15.5% in Sweden and 11.8% in Italy, and peptic ulcer in China (17.1%), both in asymptomatic and symptomatic individuals. The prevalence of Helicobacter pylori was positively associated with the prevalence of peptic ulcer (r = 0.91) but negatively associated with the prevalence of both esophagitis (r = −0.99) and ESEM (r = −0.95). Conclusions Upper gastrointestinal endoscopic findings are present in at least a quarter of subjects in the community with different patterns in Western and Eastern countries, both in asymptomatic and symptomatic subjects. H. pylori prevalence negatively impacts on the prevalence of reflux‐related esophageal findings.