Letter: Incidence rates of Barrett's oesophagus and oesophageal adenocarcinoma in the UK and the Netherlands

摘要

Sirs, I read with great interest the article by Masclee et al. who showed, in a dynamic population-based retrospective cohort study in the UK and the Netherlands that the incidence rates of Barrett's oesophagus (BO) increased from 2000 to 2003, but levelled off thereafter. I have two main concerns regarding their article. First, the relevant medical information, in the population-based registries which served as data sources, included drug prescriptions and/or use. It would have been worth knowing the yearly incidence rates, throughout the study period, of prescriptions [particularly of proton pump inhibitors (PPIs)], as compared with BO and oesophageal adenocarcinoma (OAC) incidence rates. Indeed, despite the strong rationale for the use of PPIs in BO, many clinical trials using PPIs did not show relevant BO regression.2' 3 Yet, once BO is installed, PPIs have been associated with a significant decrease in high-grade dysplasia and OAC arising from BO.