A total of 4216 patients were included. The population was predominantly female (2138 women, 50.7%). The sex ratio was 0.97. The mean age of the patients was 43.7 ± 16.5 years, ranging from 1 to 92 years. Young adults accounted for 60.9% of cases (Table 1).

Table 1. Sociodemographic characteristics of the patients.

3.2.1. Clinical Aspects

The indications for upper gastrointestinal endoscopy were numerous and varied (Table 2). The main ones were epigastric pain (47.4%), regurgitation (14.4%), and heartburn (13.9%).

Table 2. Distribution according to the indication for upper gastrointestinal endoscopy.

*: canker sores, pre-therapeutic assessment, oropharyngeal candidiasis, dysphonia, occasional aspiration, epigastric mass, intra-abdominal mass, jaundice, rumination, post-polypectomy monitoring, sensation of a lump in the esophagus, sensation of a foreign body in the esophagus, stricture syndrome, chronic laryngitis, asthenia, edema-ascitic syndrome.

3.2.2. Endoscopic Aspects

During endoscopy, hiatal hernias were mainly observed in 60.6% of cases and peptic esophagitis in 52.6% (Figure 1).

Figure 1. Distribution of patients according to endoscopic lesions found.

• Histology

Squamous cell carcinoma (58%) and adenocarcinoma (42%) were the most common histological types of esophageal cancer.

• Distribution of esophageal pathologies by age group

Peptic esophagitis predominated in children and young adults, accounting for 71.7% and 58.2% of cases, respectively. In individuals over 50, hiatal hernia was more common (66.6%). The proportion of esophageal tumors increased with age. It was observed in 1.3% of the elderly and 0.2% of young adults, and was not found in children (Table 3).

Table 3. Distribution of major pathologies and esophageal cancer by age group.

Multivariate Analysis

There was a statistically significant association for all three pathologies with age and one with sex for peptic esophagitis and esophageal cancer. Men were 2.93 times more likely to develop cancer than women (Table 4).

Table 4. Multivariate analysis of sociodemographic factors associated with the main esophageal pathologies and esophageal cancer.

This study, being retrospective in nature, is based on the analysis of hospital records, which may lead to missing data or selection biases. Furthermore, conducted in a university hospital, it reflects the hospitalized population rather than the general population, limiting the generalizability of the results. Despite these constraints, it provides useful insights into local trends and can guide future prospective studies.

Esophageal pathology, excluding cancer, mainly affects young adults and women, as found in several studies [4][5]. In our study, peptic esophagitis and hiatal hernia were the most common esophageal pathologies, while esophageal cancers were rare. These results are consistent with previous studies conducted in sub-Saharan Africa, which report a low incidence of esophageal cancer, particularly. adenocarcinoma, compared to other regions of the world [6].

Regarding peptic esophagitis, the risk decreased with age and it seemed more common in women (OR = 1.18; p = 0.01) and children. As for hiatal hernia, the risk increased significantly with age, reaching a peak in those aged 50 and over (OR = 2.51; p <0.001). These results are consistent with international epidemiological data showing that aging of the diaphragm muscles and loosening of muscle fibers increase the risk of hiatal hernia [7][8]. Malignant tumors of the esophagus were rare in our series, but the risk increased sharply from age 50 (OR = 12.3; p = 0.020). They were more common in men (OR = 0.35; p = 0.046). These observations are consistent with global data showing that esophageal cancers mainly occur in older men [9]. Other African authors have emphasized the rarity of this cancer in our context [10]-[12]. Behavioral factors such as tobacco, alcohol, and the consumption of very hot foods, documented in Burkina Faso and other sub-Saharan countries, may contribute to these differences in distribution by sex and age [8].