Epidemiology of GERD, Barrett's Esophagus and Esophageal Cancer

Gastroesophageal reflux disease (GERD) is increasingly prevalent worldwide, particularly in the Western world, where reflux symptoms have a prevalence of up to 40% in population‐based studies. However, accurate estimates of GERD prevalence are hampered by the lack of a standard, symptom‐based disease definition, by diagnostic overlap with other conditions and by the finding that erosive reflux esophagitis is not uncommon in asymptomatic individuals. GERD is a risk factor for both Barrett's esophagus and esophageal adenocarcinoma but not for esophageal squamous cell cancer. The increasing incidence of esophageal adenocarcinoma appears to be slowing and the risk of esophageal adenocarcinoma in nondysplastic Barrett's esophagus is lower than that reported previously. Despite numerous studies, the reasons for the changing prevalence of GERD and its sequelae remain unknown; obesity is associated strongly with an increased risk of GERD but other genetic and environmental factors, implicated in the pathogenesis of GERD, merit further study as do interventional strategies to reduce or prevent the development of esophageal cancer.