Opportunities for esophageal cancer screening

Tom Vaughan

10 May 2022 — 1 min read

Using the VA Central Cancer Registry, the authors investigated opportunites to undergo screening for esophageal adenocarcinoma (EAC), finding more than 80% of cancer patients had not undergone prior upper endoscopy, even though the vast majority had potential opportunities.

Gastroenterology. 2021 Dec 20;S0016-5085(21)04091-9. doi: 10.1053/j.gastro.2021.12.255. Online ahead of print.

Patients with Adenocarcinoma of the Esophagus or Esophagogastric Junction Frequently Have Potential Screening Opportunities

Joel H Rubenstein 1, Richard R Evans 2, Jennifer A Burns 2, Maria E Arasim 2, Ji Zhu 3, Akbar K Waljee 4, Harnessing Opportunities to Screen for Esophageal Adenocarcinoma Group; Peter W Macdonald 3, Megan A Adams 4, Joy W Chang 5, Elizabeth M Firsht 2, Sarah T Hawley 6, Sameer D Saini 4, Lauren P Wallner 7

PMID: 34942170 DOI: 10.1053/j.gastro.2021.12.255

Abstract

Symptoms of gastroesophageal reflux disease (GERD) are risk factors for Barrett’s esophagus (BE) and esophageal adenocarcinoma (EAC). Guidelines recommend considering endoscopic screening for patients with GERD and additional risk factors.1 Screening programs can fail due to failure of uptake of initial screening or of surveillance among those with known BE. Prior studies have demonstrated that fewer than 20% of patients with EAC had an esophagogastroduodenoscopy (EGD) before diagnosis of cancer, but were typically defined as an EGD within just a few years before. 2-5 Those studies also did not address whether there were potential opportunities to undergo screening. Such opportunities could include encounters for GERD, prescription of acid-reducing medications, or for colorectal cancer screening. We quantified the proportion and types of potential opportunities for screening and surveillance among individuals who later developed EAC. Because esophagogastric junction adenocarcinoma (EGJAC) shares many risk factors with EAC we also explored the same opportunities for EGJAC.

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