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,
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
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
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
An evidence-based compendium of recommended treatments
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
Using data from the previously published BEST3 clinical trial (1), the authors estimated the potential for improving the detection of Barrett's esophagus (BE) and early esophageal adenocarcinoma (EAC) among individuals aged 50 and above with gastroesophageal reflux disease (GERD). They calculated that the current referral strategies identify only
Exposure to asbestos, whether through occupational or environmental routes, can cause several cancers, including mesothelioma and lung. It’s role in increasing risk of esophageal cancer (EC) has long been suspected, but not yet confirmed. In this thorough meta-analysis, 48 independent cohort and case-control studies were analyzed using random-effects models
This study provides valuable context for patients and their physicians concerned about future health implications of their diagnosis and treatment for Barrett's neoplasia (dysplasia or early cancer.) It investigates the risk of mortality unrelated to esophageal adenocarcinoma (EAC) in patients who have undergone endoscopic eradication therapy (EET) for
In exciting news on the prevention/screening front, The Fred Hutchinson Cancer Center is leading a new clinical trials consortium called the Cancer Screening Research Network (CSRN), established by the National Cancer Institute, with the aim of advancing President Biden’s Cancer Moonshot initiative. The CSRN will focus on improving
While not breaking new ground, this manuscript from Mayo Clinic nicely reviews state of the art approaches to screening (and surveillance) for Barrett's esophagus and esophageal adenocarcinoma. These newer techniques including: three different swallowable cell sampling devices combined with biomarkers (now approved in society guidelines), capsule-based imaging, and
Does bariatric surgery influence subsequent risk of esophageal adenocarcinoma? Depending on whom and when you ask, what population or subpopulation you study, and which surgical procedures are considered, studies variously suggest no effect, increased risk and reduced risk. Moreover, some of the apparently discrepant results originate from the same author
There is currently a great deal of interest in the role of Artifical Intelligence (AI) in medicine, particularly in specialties involving visualization. Upper gastrointestinal endoscopy, employed in the screening, surveillance and diagnosis of esophageal and gastric cancer and their precursors, is one such area that is especially promising in increasing
This large multinational observational study investigated whether bariatric surgery was associated with reduced risk of esophageal and cardia adenocarcinoma (ECA) in individuals diagnosed with “morbid” obesity. The study involved a cohort of almost 750,000 persons from Sweden, Finland, and Denmark, grouped based on whether they underwent bariatric surgery (n=
This prospective cohort study conducted in China aimed to assess the association between long-term exposure to fine particulate matter (PM2.5) and risk of esophageal cancer. The study included over 510,000 participants without esophageal cancer at the beginning of the study and used a high-resolution satellite-based model to estimate
While the ESOCAN website and blog focus on the epidemiology and prevention of esophageal cancer, this review gives insight into recent and developing approaches to the management of esophageal squamous cell and adenocarcinoma. Key points that the authors highlight include: • With advances in molecular profiling technologies, the diferential mechanistic underpinnings
In this unusual and very in-depth review, Dr. Sijben and colleagues perform a qualitative analysis of professional’s views on the justification for systematic screening for esophageal adenocarcinoma (EAC), a topic of much discussion. The findings suggest that professionals in the field are increasingly supportive of targeted screening (as opposed
The following summary made use of an accompanying comment by Drs. Dawsey and Duit: A substantial advance for screening of oesophageal cancer - PubMedA substantial advance for screening of oesophageal cancerPubMedSanford M Dawsey This report discusses the high prevalence of esophageal squamous cell cancer, particularly in low-income and middle-income countries,
This study aimed to investigate whether bariatric surgery is associated with an increased risk of developing esophagogastric carcinoma, using a retrospective design and data from a very large national administrative database of hospital discharges in France. The analysis revealed that bariatric surgery was not associated with an additional risk of
Radio frequency ablation (RFA) has become a standard of care for persons with advanced dysplasia in Barrett's, but little has been published regarding the occurrence and predictors of post-procedure symptoms. This study aimed to describe the course of post-RFA symptoms and identify possible associated risk factors in patients
The article discusses the findings of a community-based, multicenter, prospective cohort study on endoscopic surveillance for premalignant esophageal lesions in rural China. The study aimed to assess the incidence and risk factors for advanced neoplasia in patients with mild-moderate dysplasia. The results showed that most patients with mild-moderate dysplasia stabilized
While not exactly a streetfight, Drs. Spechler and El-Serag briefly discuss in this "point/counterpoint" possible reasons that current screening approaches for esophageal adenocarcinoma and Barrett's esophagus have had only modest success in affecting incidence and mortality for this cancer. I note that neither author mentions
This review nicely updates the status of screening programs for Barrett's esophagus and esophageal adenocarcinoma, with and emphasis on established and newer non-invasive methods. The Horizon of Screening for Barrett's Esophagus and Esophageal Cancer Techniques and Innovations in Gastrointestinal Endoscopy, 2023 https://doi.org/10.1016/
There are a few recent reports that the incidence of EA has increased in young adults, and that they are being diagnosed at a later stage. In an analysis of nine SEER population-based cancer registries from 1975-2015, Codipilly, et al. reported an approximate tripling of incidence in persons less than