PWE-121 The incidence of achalasia in england and its association to deprivation and ethnicity

Field: Medicine (Health Sciences)

<sec><st>Introduction</st> Achalasia is an uncommon condition characterised by failed relaxation of the lower oesophageal sphincter. There is very limited data on its incidence and associated risk factors at population level. <tbl id="table1" loc="float"><tblbdy top-stubs="2"><r><c cspan="1" rspan="1"> </c><c cspan="1" rspan="1"> </c><c cspan="1" rspan="1"><b>Number of subjects</b> </c><c cspan="1" rspan="1"><b>Observed%</b> </c><c cspan="1" rspan="1"><b>Population%</b> </c><c cspan="1" rspan="1"><b>p value</b> </c></r><r><c cspan="6" rspan="1"><bottom-border> </c></r><r><c cspan="1" rspan="2"><b>Sex</b> </c><c cspan="1" rspan="1">Male </c><c cspan="1" rspan="1">5226 </c><c cspan="1" rspan="1">49.73 </c><c cspan="1" rspan="1">50.27 </c><c cspan="1" rspan="2">p=0.2569 </c></r><r><c cspan="1" rspan="1">Female </c><c cspan="1" rspan="1">5283 </c><c cspan="1" rspan="1">50.27 </c><c cspan="1" rspan="1">49.73 </c></r><r><c cspan="1" rspan="6"><b>Deprivation Quintile</b><br>*Where 1 is the most deprived </c><c cspan="1" rspan="1">1 </c><c cspan="1" rspan="1">1848 </c><c cspan="1" rspan="1">17.58 </c><c cspan="1" rspan="1">20.08 </c><c cspan="1" rspan="6">p<0.0001 </c></r><r><c cspan="1" rspan="1">2 </c><c cspan="1" rspan="1">2094 </c><c cspan="1" rspan="1">19.93 </c><c cspan="1" rspan="1">20.27 </c></r><r><c cspan="1" rspan="1">3 </c><c cspan="1" rspan="1">2176 </c><c cspan="1" rspan="1">20.71 </c><c cspan="1" rspan="1">20.06 </c></r><r><c cspan="1" rspan="1">4 </c><c cspan="1" rspan="1">2199 </c><c cspan="1" rspan="1">20.92 </c><c cspan="1" rspan="1">19.89 </c></r><r><c cspan="1" rspan="1">5 </c><c cspan="1" rspan="1">2173 </c><c cspan="1" rspan="1">20.68 </c><c cspan="1" rspan="1">19.7 </c></r><r><c cspan="1" rspan="1">Unknown </c><c cspan="1" rspan="1">19 </c><c cspan="1" rspan="1">0.18 </c><c cspan="1" rspan="1">- </c></r><r><c cspan="1" rspan="6"><b>Ethnic Group</b> </c><c cspan="1" rspan="1">White </c><c cspan="1" rspan="1">9117 </c><c cspan="1" rspan="1">86.75 </c><c cspan="1" rspan="1">85.41 </c><c cspan="1" rspan="6">p<0.0001 </c></r><r><c cspan="1" rspan="1">Asian or Asian British </c><c cspan="1" rspan="1">79 </c><c cspan="1" rspan="1">0.75 </c><c cspan="1" rspan="1">7.82 </c></r><r><c cspan="1" rspan="1">Black or Black British </c><c cspan="1" rspan="1">480 </c><c cspan="1" rspan="1">4.57 </c><c cspan="1" rspan="1">3.49 </c></r><r><c cspan="1" rspan="1">Mixed </c><c cspan="1" rspan="1">282 </c><c cspan="1" rspan="1">2.68 </c><c cspan="1" rspan="1">2.26 </c></r><r><c cspan="1" rspan="1">Any other ethnic group </c><c cspan="1" rspan="1">176 </c><c cspan="1" rspan="1">1.67 </c><c cspan="1" rspan="1">1.03 </c></r><r><c cspan="1" rspan="1">Unknown </c><c cspan="1" rspan="1">375 </c><c cspan="1" rspan="1">3.57 </c><c cspan="1" rspan="1">- </c></r></tblbdy></tbl> </sec> <sec><st>Method</st> The Hospital Episode Statistics (HES) database includes demographic, diagnostic and administrative data for all hospital admissions in England. All subjects with an ICD10 code for achalasia in the primary position between 2006 and 2016 were examined. Demographic data was collated and compared with population data from the Office for national statistics (ONS) with the exception of ethnicity which was only available for the census year (2011). Comparison between the achalasia cohort and the background population was performed using Chi2 test. </sec> <sec><st>Results</st> There were 10 509 new achalasia diagnoses during the study period. The mean incidence over the study period was 1.99 (CI 1.87–2.11) per 1 00 000. This rose from 1.73 (1.62–1.85) per 1 00 000 in 2006 to 2.24 (2.11–2.36) per 1 00 000 in 2015. This is an increase of 0.51 per 1 00 000 over the 10 year period. Gender, ethnicity and index of multiple deprivations data are presented in table below including statistical comparison with the English population. Observed ethnicity and deprivation distributions were noted to be significantly different to those expected from the general population. </sec> <sec><st>Conclusion</st> The incidence of achalasia has risen over the past 10 years to 2.24 per 1 00 000. Achalasia is more common in less deprived subjects. There are also significantly fewer Asian subjects with achalasia than would be expected from the background population. </sec> <sec><st>Disclosure of Interest</st> None Declared </sec>