Risk factors and populations at risk: selection of patients for screening for Barrett's oesophagus.
Screening for Barrett's oesophagus is an attractive notion due to the rising incidence of oesophageal adenocarcinoma, the relative ease of acquiring tissue from the oesophagus, and the availability of endoscopic therapy for early neoplastic lesions. If screening is recommended, the question remains: which patients should be screened? Endoscopy is frequently performed in patients with symptoms of gastro-oesophageal reflux disease, but the vast majority of patients diagnosed with oesophageal adenocarcinoma have never undergone a prior endoscopy. The efficiency of screening needs to be improved. A number of tools for predicting the presence of Barrett's oesophagus or future risk of developing oesophageal adenocarcinoma are available. More research is needed to validate these tools and to identify the thresholds at which screening should be offered.
Veterans Affairs Center for Clinical Management Research, Ann Arbor, MI, USA; Division of Gastroenterology, University of Michigan Medical School, Ann Arbor, MI, USA. Electronic address: jhr@umich.edu.
Joel H
JH
Rubenstein
Department of Medicine and Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX, USA; Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
Aaron P
AP
Thrift
D000230:Adenocarcinoma / Q000209:etiology / Q000517:prevention & control*; D001471:Barrett Esophagus / Q000175:diagnosis*; D055088:Early Detection of Cancer / Q000379:methods*; D004938:Esophageal Neoplasms / Q000209:etiology / Q000517:prevention & control*; D004945:Esophagoscopy; D005764:Gastroesophageal Reflux / Q000150:complications / Q000209:etiology; D006801:Humans; D018579:Patient Selection; D011230:Precancerous Conditions / Q000175:diagnosis*; D012307:Risk Factors
Barrett's oesophagus; Mass screening; Oesophageal neoplasms; Risk assessment