2014-06-03 19:08:03 UTC

Esophageal Cancer: How Far Should We Screen?

June 5, 2014

By performing endoscopic surveillance on Barrett’s esophagus patients, we can detect high-grade dysplasia and cancer at early stages. So, should we perform screening endoscopies to identify all patients with Barrett’s?

The author of an AGA Perspectives article on this topic, Julian A. Abrams, MD, MS, blogged about the issue on Medpage Today’s KevinMD, social media’s leading physician voice.

The incidence of esophageal adenocarcinoma has increased more than five-fold over the past four decades in the U.S. While the rate of rise in incidence of esophageal cancer has slowed somewhat in recent years, this malignancy is still associated with a dismal prognosis.

Barrett’s esophagus, the precursor lesion to esophageal cancer, is easily identifiable on routine upper endoscopy and can be monitored for the development of precancerous changes. We generally assume that by performing endoscopic surveillance in our Barrett’s patients, we can detect high-grade dysplasia and esophageal cancer at early stages when it is still easily treatable. Therefore, should we not perform screening endoscopies with the goal of identifying all patients with Barrett’s esophagus?

Julian A. Abrams, MD, MS, answers this complicated question in a blog post on KevinMD.

Dr. Abrams originally shared his thoughts on this topic in AGA Perspectives.

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