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Achalasia incidence in Chicago two times greater than previous estimate
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The incidence and prevalence of achalasia in central Chicago diagnosed using high-resolution manometry are two to three times greater than the previous estimates, according to recent findings published in Clinical Gastroenterology and Hepatology.
“Although substantially greater than previously reported, our achalasia incidence estimate for the [Northwestern Memorial Hospital (NMH)] neighborhood was still likely an under-estimate because it assumed that every incident achalasia case in the NMH neighborhood was diagnosed and that every incident case was managed at NMH,” Salih Samo, MD, MSCI, in the division of gastroenterology and hepatology at Northwestern University Feinberg School of Medicine, and colleagues wrote. “Clearly, neither of these assumptions was true.”
The CDC defines achalasia as the inability of the lower esophageal sphincter to relax. Achalasia’s global incidence values vary from 0.03 to 1.63 per 100,000 people per year and prevalence values vary from 1.8 to 12.6, the researchers wrote. In 2005, a major referral center in central Chicago began using high-resolution manometry for all its clinical studies. Samo and colleagues hypothesized that the newer technology would lead to more accurate incidence and prevalence data for achalasia.
The researchers collected data from the Northwestern Medicine Enterprise Data Warehouse database of adults living in Chicago and diagnosed with achalasia between 2004 and 2013. The researchers also used U.S. Census Bureau population data. They assessed data for Chicago as well as the 13 zip codes surrounding NMH, which they defined as the NMH neighborhood.
They found 379 cases of achalasia in Chicago; 246 were incident cases and 132 lived in the NMH neighborhood. Of those living in the NMH neighborhood, 89 were incident cases. The yearly incident rate ranged from 0.77 to 1.35 per 100,000 in all of Chicago and from 1.41 to 4.6 in the NMH neighborhood. The yearly prevalence ranged from 4.68 to 14.42 per 100,000 in Chicago and from 15.64 to 32.58 in the NMH neighborhood.
The researchers concluded that the incidence and prevalence were two- to threefold greater than previous estimates.
“We speculate that the higher rates are due to recent advancements in diagnostics in high-resolution manometry and diagnostic criteria and enhanced awareness of the disease,” the researchers wrote. “Additional studies are needed to determine the generalizability of these data to other regions.” – by Will Offit
Disclosure: Samo reports no relevant financial disclosures. Please see the full study for a list of all other researchers’ relevant financial disclosures.
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