This nice review updates the molecular/genomic changes leading to esophageal adenocarcinoma and makes the link to more effective screening and treatment approaches.
A meta-analysis of 34 studies of occupational exposure to asbestos reveals a 28% increased risk of esophageal squamous cell carcinoma, which increased to 84% among those most highly exposed.
Family history of Barrett's and/or EAC was determined in 480 BE patients and 420 controls and validated using the Dutch nationwide histopathology database. A positive family history was found in 6.5% of BE patients, which is consistent with other studies, yielding a five-fold increased risk.
Drs. Xie and colleagues observed a decreased risk of esophageal adenocarcinoma among women taking post-menopausal hormones in this population-based cohort study in Sweden with 693 EAC cases. This supports the concept that female sex hormones contribute to the lower incidence of EAC in women.
This Review by Dr. Thrift at Baylor updates the trends in the incidence of esophageal cancer (both histologic types) and summarizes current knowledge of its risk factors.
A nice review of prevention approaches to both esophageal squamous cell carcinoma and adenocarcinoma. It includes a summary of surveillance methods and intervals recommended by four GI societies
This report focuses on esophageal cancer mortality trends in the US from 1992-2016. The dramatic decrease in ESCC among black males over the past several decades is highlighted. The recent leveling off of mortality for esophageal adenocarcinoma in white males was observed to continue.
In this remarkably thorough review, Drs. Elliott and Reynolds summarize the evidence for and potential mechanisms underlying the association between visceral obesity and esophageal adenocarcinoma.
Gastroenterology societies recommend surveillance for non-dysplastic Barrett's but do not give guidance on when to stop. This modeling study suggests that the optimal age for last surveillance of NDBE patients depends on the sex and the comorbidity level of patients.
The authors review the incidence of BE and EAC and associated risk factors, evidence for improved outcomes among patients with a prior diagnosis of BE compared to those without, and the challenges of developing accurate prediction models in the context of high population prevalence of risk factors.
A SEER-based observational study lends yet more evidence that aspirin, PPIs, statins and possibly metformin may reduce risk of EAC in persons with or without diagnosed Barrett's esophagus.
This impressive randomized trial observed an approximately 10-fold increase in detection of Barrett's with use of the Cytosponge non-endoscopic test. Nine persons in the Cytosponge group were found to have treatable dysplasia or early stage cancer vs. none in the usual care group.