research
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.
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.