Screening and early diagnosis of upper GI neoplastic lesions: dedicated journal issue

The journal "Best Practice & Research Clinical Gastroenterology" has dedicated an entire issue toward research on the secondary prevention of esophageal and other upper GI cancers. These review articles include such topics as artificial intelligence, risk-based screening and cost effectiveness. Rather than summarizing these 12 informative articles, I

Improvements in post-surgical mortality for esophageal cancer

Although esophageal cancer remains one of the most deadly cancers, this Swedish population-based study from the Karolinska Institutet documents steady improvement in five-year survival rates over the past two decades. Among 2,291 patients undergoing esophageal cancer surgery, survival increased by about 3% per year despite patients being older and

Real-world experience with capsule sponge test

This large prospective observational study evaluated the potential usefulness of the Capsule Sponge (CS) test – a non-invasive method of collecting cellular samples from the esophageal lining – in a "real-world" setting at multiple NHS hospitals in the UK. Among the 2,170 patients who had a CS test, there

Circulating tumor DNA and recurrence of esophagogastric cancer

Persons with esophagogastric adenocarcinoma who undergo neoadjuvant therapy and curative-intent surgery are unfortunately still at risk for recurrence even with pathological complete (or near-complete) treatment response. If those likely to experience recurrence could be identified early they might benefit from additional treatment such as immunotherapy. This preliminary study investigates the

Cost-effectiveness analysis of Barrett's screening

From South Australia's Flinders University, Dr. Aoki and colleagues report on a cost-effectiveness analysis of various screening strategies for identifying Barrett's esophagus (BE) in the community, The study examined four primary screening tools: non-weighted clinical risk stratification, weighted risk stratification, the Cytosponge-TFF3 device, and traditional endoscopy

Liquid biopsy to diagnose esophageal adenocarcinoma

This impressive multicenter study by Miyoshi et al. introduces a new diagnostic tool named EMERALD, which is a six-circulating miRNA signature designed to effectively differentiate patients with esophageal adenocarcinoma (EAC) and its precursor, Barrett's esophagus (BE), from non-disease controls. The research involved analyzing 792 patient samples across four

Neoplastic progression in young Barrett's patients

Esophageal adenocarcinoma is quite rare among persons younger than 40 years, but the consequences of the disease, including years of life lost, can be devastating. Due to its rarity there has been little research on how risk factors in young persons (e.g., Barrett's esophagus (BE), obesity, GERD,

Diagnosis and management of GERD

While most adults occasionally experience symptoms of gastroesophageal reflux, such as heartburn and regurgitation, approximately 20% (30 million people in the U.S.) experience these symptoms more frequently, ranging from once a week to multiple times a day. (1) Complications associated with GERD can include esophageal strictures, ulcers, and even

Ethics of screening based on race/ethnicity

This article explores some of the ethical implications of using race and ethnicity for cancer screening, using esophageal adenocarcinoma and gastric cancer as examples. It highlights the disparities in cancer incidence and mortality among different racial and ethnic groups and examines the potential benefits and drawbacks of screening based (in

Tension between risk-based and patient-centered esophageal cancer screening

This interesting and thoughtful paper by Dr. Elspeth Davies at the University of Cambridge investigates the use of the capsule sponge test for screening Barrett's esophagus (BE) in a mobile clinic in England, highlighting the challenges in balancing patient-centered and risk-centered medical management. Through ethnographic fieldwork, the study

Eradication therapy for Barrett's

An evidence-based compendium of recommended treatments

AI in the assessment of Barrett's neoplasia

Accurate and timely identification of Barrett’s-related (BE) dysplasia is critical to providing the timely surveillance and treatment needed to prevent progression to esophageal adenocarcinoma. Unfortunately, significant observer variability in the assessment of BE-related dysplasia by pathologists continues to be a challenge. This report discusses the development and application of