Important guideline updates include the recommendations for nonendoscopic screening methods, longer intervals for short-segment BE surveillance, and specific suggestions for post-ablation surveillance. Am J Gastroenterol. 2022 Apr 1;117(4):559-587. doi: 10.14309/ajg.0000000000001680. Diagnosis and Management of Barrett's Esophagus: An Updated ACG Guideline Nicholas J
The authors calculated temporal trends in esophageal adenocarcinoma from 1989-2016 in the Netherlands, finding substantial increases. They projected rates about 30% higher in the late 2030's. Int J Cancer. 2022 Feb 1;150(3):420-430. doi: 10.1002/ijc.33836. Epub 2021 Oct 16. Trends and projections in
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A large multi-center study across three countries in east Africa confirms the significant role that alcohol intake plays in the public health burden of esophageal squamous cell carcinoma in these countries, particularly among men. Lancet Glob Health. 2022 Feb;10(2):e236-e245. doi: 10.1016/S2214-109X(21)00506-4. Epub 2021
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.
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Dr. Matt Buas and colleagues analyzed clinical and lifestyle factors among 371 persons with esophageal adenocarcinoma. A number of factors correlated with improved survival, depending on stage. Among those with localized or regional tumors, smoking was associated with a 2.5-fold increased mortality. Cancers (Basel). 2021 Sep 16;13(18)
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Proton pump inhibitors (PPIs) are commonly used to treat reflux, a key risk factor for esophageal adenocarcinoma. However, they have the potential for side effects. This expert review provides "best practice advice" for de-prescribing PPIs. Gastroenterology. 2022 Feb 16;S0016-5085(21)04083-X. doi:10.1053/j.gastro.2021.
In addition to serving as a minimally invasive screening tool to help identify persons with Barrett's (BE), dysplasia and early stage esophageal adenocarcinoma, the Cytosponge (and similar devices) also have a potentially important role in long term surveillance of persons with BE. Lancet Oncol. 2022 Feb;23(2)
Results from a study from a high-risk area in China indicate that esopphageal cells captured non-invasively via a capsule sponge, when combined with a trained artificial intelligence (AI) system can substantially reduce the need for endoscopy with histopathology, with a sensitivity of 93.7%.
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.