S907 Epidemiological Trends in New Diagnoses of Barrett's Esophagus Suggest No Gender Difference Within 2 Decades

Introduction: Barrett’s esophagus (BE) and esophageal adenocarcinoma (EA) are more common in men than women. Previous studies demonstrated a 70% lower prevalence rate of BE in women compared to men. However, new BE diagnoses appear to be increasing among women. This study aims to estimate future demographic changes in patients diagnosed with BE and EA. Methods: A large nationwide population-based database study was conducted using the United States TriNetX Platform. Percentage of new BE cases divided by gender were compared over the years 2010 to 2024 and linear regression was used to trend future changes in diagnosis by sex. Patients who were diagnosed with BE in 2010 were followed to compare progression to EA between genders. Cohorts were balanced for age at diagnosis, race, ethnicity, history of gastroesophageal reflux disease (GERD), nicotine dependence, and obesity. Odds ratios were utilized to assess progression to EA. Results: Of 7,941 new BE patients in 2010, 60% were men and 40% were women. The average age was 60.3 years. The group was 83% White, 2% Black, and 3.5% Asian, with the remainder having other or unknown race. In addition, 3.6% were Hispanic or Latino. Overall, 76% of the patients were diagnosed with GERD, 38% with hiatal hernia, 15% with obesity, and 24% with nicotine dependence. In contrast, there were 27,639 new BE patients in 2024, of whom 56% were men and 44% women. The average age was 63.8 years. This group was 83% White, 4% Black, and 3.5% Asian, with the rest having other or unknown race. Additionally, 5.3% were Hispanic or Latino. In this group, 74% of patients were diagnosed with GERD, 39% with hiatal hernia, 25% with obesity, and 25% with nicotine dependence. Linear regression comparing new diagnoses of BE by gender showed that if current trends continue, the difference in new diagnoses between genders will disappear by the year 2045 (R² = 0.72). Of new BE patients in 2010, 2.5% of men and 0.7% of women developed EA during the 14 years of follow-up of this study. When matched for major risk factors for BE, men had 3.3 times the odds (95% confidence interval 2.21; 4.89) of developing EA compared to women. Conclusion: Our findings suggest that within 2 decades, men and women will comprise equal proportions of new BE cases. However, EA will continue to affect men at over 3 times the rate observed in women. Whether this will shift as more women are diagnosed with BE remains to be elucidated.