Preventing death of Barrett's cancer: does frequent surveillance endoscopy do it?
Patients experiencing gastroesophageal reflux may be predisposed to developing Barrett's esophagus, which is thought to be a precursor for the development of esophageal cancer. Currently, endoscopic surveillance is recommended for patients with Barrett's esophagus in the hope that esophageal cancer may be detected or even prevented. However, the frequency of endoscopic evaluations is a matter of debate. This article will examine whether regular endoscopic surveillance can prevent death of Barrett's cancer. The issues that are evaluated include the death rate from esophageal cancer, the need to scope all patients with reflux, the need to perform surveillance on all patients with Barrett's esophagus, survival data for Barrett's patients, and the incidence of nonsymptomatic Barrett's cancer.
Sontag
S J
SJ
Department of Veterans Affairs Medical Center, Hines Veterans Affairs Hospital, 151B3 Building 1, Room B321, Hines, Illinois 60141-5199, USA. Stephen.Sontag@med.VA.gov
D001471:Barrett Esophagus / Q000401:mortality* / Q000473:pathology*; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000517:prevention & control*; D004945:Esophagoscopy / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic; D009367:Neoplasm Staging; D011159:Population Surveillance; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D013997:Time Factors