Old age and male sex are associated with increased risk of asymptomatic erosive esophagitis: Analysis of data from local health examinations by the Korean National Health Insurance Corporation

Background and Aims: Silent gastroesophageal reflux disease (GERD) is often detected during routine screening esophagogastroduodenoscopy (EGD). However, the risk factors and clinical implications of silent GERD remain unclear. In the present study, we investigated the risk factors for asymptomatic erosive esophagitis by analyzing the local area health examination data. Methods: The Korean National Health Insurance Corporation provides a bi-annual health examination performed by qualified local hospitals for the early detection of cancer in medical insurance holders over 40years of age. Participants who completed self-reported questionnaires on health, followed by EGD at the Myongji Hospital (Goyang, Korea), were enrolled in this study. Results: The data of a total of 5301 participants who underwent EGD between January 2005 and December 2008 were analyzed. The prevalence of erosive esophagitis was 6%. In the multivariate analysis, erosive esophagitis was strongly associated with an age greater than 60years (odds ratio [OR]: 0.7, 95% confidence interval [CI]: 0.6-1.0), male sex (OR: 2.3, 95% CI: 1.7-3.0), hiatus hernia (OR: 2.9, 95% CI: 2.1-4.0), duodenal ulcer (OR: 1.6, 95% CI: 1.1-2.5), hypertension (OR: 1.5, 95% CI: 1.2-2.0), and smoking (OR: 1.4, 95% CI: 1.0-1.8). Of the 320 participants with erosive esophagitis, 145 (45.3%) were asymptomatic participants, and those who were more frequently greater than 60years (OR: 1.8, 95% CI: 1.1-3.1) and male (OR: 1.8, 95% CI: 1.1-3.2). Conclusions: Asymptomatic erosive esophagitis in adults older than 40years is strongly associated with old age (≥60years) and male sex compared with symptomatic erosive esophagitis.