Barrett's esophagus and cancer risk: how research advances can impact clinical practice.

Abstract:

:Barrett's esophagus (BE) is the only known precursor to esophageal adenocarcinoma (EAC), whose incidence has increased sharply in the last 4 decades. The annual conversion rate of BE to cancer is significant, but small. The identification of patients at a higher risk of cancer therefore poses a clinical conundrum. Currently, endoscopic surveillance is recommended in BE patients, with the aim of diagnosing either dysplasia or cancer at early stages, both of which are curable with minimally invasive endoscopic techniques. There is a large variation in clinical practice for endoscopic surveillance, and dysplasia as a marker of increased risk is affected by sampling error and high interobserver variability. Screening programs have not yet been formally accepted, mainly due to the economic burden that would be generated by upper gastrointestinal endoscopy. Screening programs have not yet been formally accepted, mainly due to the economic burden that would be generated by widespread indication to upper gastrointestinal endoscopy. In fact, it is currently difficult to formulate an accurate algorithm to confidently target the population at risk, based on the known clinical risk factors for BE and EAC. This review will focus on the clinical and molecular factors that are involved in the development of BE and its conversion to cancer and on how increased knowledge in these areas can improve the clinical management of the disease.

journal_name

Gut Liver

journal_title

Gut and liver

authors

di Pietro M,Alzoubaidi D,Fitzgerald RC

doi

10.5009/gnl.2014.8.4.356

subject

Has Abstract

pub_date

2014-07-01 00:00:00

pages

356-70

issue

4

eissn

1976-2283

issn

2005-1212

pii

gnl-8-356

journal_volume

8

pub_type

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