Epidemiology

Achalasia may occur at any age; however, incidence increases with age. The median age at diagnosis is 53 years.[1] Achalasia affects both sexes equally.[1][2]

Geographic, ethnic, and temporal differences have been reported for the prevalence and incidence of achalasia. Incidence rates of 2.92/100,000 persons per year and 2.3 to 2.8/100,000 persons per year have been reported in North America and South Australia.[3][4]​ The incidence in Korea is 0.39/100,000 persons per year, in Zimbabwe is 0.03/100,000 persons per year, and in Singapore is 0.3/100,000 persons per year.[5][6][7]

Estimates of prevalence range from 8.0/100,000 persons per year to 27.1/100,000 persons per year.[1][2][8][9]​​

Some studies demonstrate increasing incidence and prevalence over time.[1][2][10]​​ In the US, there has been an increase in the number of Heller myotomies performed, with a concomitant increase in utilization of the laparoscopic rather than the open approach.[11] The study authors concluded that these findings likely reflect increased disease prevalence alongside improving surgical technique (and, therefore, a concomitant growth in the number of surgical candidates).[11]

Racial differences have been highlighted in some studies, with a study from New Zealand showing a higher incidence of achalasia in Pacific Islanders and people of Maori descent than in white people.[12] In Singapore, one study found that achalasia was more common in Chinese and Indian people than in Malay people.[7] In the US, achalasia occurs at a similar rate in people of all races.[13]

Regional and ethnic variations in the incidence of achalasia suggest a role for both environmental and genetic factors in its etiology.

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