Esophageal Adenocarcinoma: Screening, Surveillance, and Management.
Esophageal adenocarcinoma (EAC) is a growing problem with a rapidly rising incidence. Risk factors include gastroesophageal reflux disease, central obesity, and smoking. The prognosis of EAC remains poor because it is usually diagnosed late, and many efforts have been made to improve prevention, early detection, and treatment. Acid suppression, nonsteroidal antiinflammatory drugs (NSAIDs), and statins may play a role in chemoprevention. Screening for Barrett's esophagus (BE), the only known precursor lesion of EAC, is indicated for individuals with increased risk. Endoscopic surveillance of patients with BE likely improves overall outcomes. Endoscopic ablation and resection is highly effective for treating dysplastic BE and early EAC, whereas esophagectomy is indicated for patients with locally advanced disease. This review covers epidemiology, staging, screening, and prevention of EAC as well as endoscopic and surgical management.
Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, Texas 77030; email: Nabil.Mansour@bcm.edu , anandasa@bcm.edu.
Nabil M
NM
Mansour
Division of Thoracic Surgery, Baylor College of Medicine, Houston, Texas 77030; email: Shawn.Groth@bcm.edu.
Shawn S
SS
Groth
Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, Texas 77030; email: Nabil.Mansour@bcm.edu , anandasa@bcm.edu.
Sharmila
S
Anandasabapathy
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000453:epidemiology / Q000556:secondary / Q000628:therapy*; D001471:Barrett Esophagus / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy*; D017115:Catheter Ablation; D018890:Chemoprevention; D055088:Early Detection of Cancer; D000069916:Endoscopic Mucosal Resection; D004938:Esophageal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology / Q000628:therapy*; D016629:Esophagectomy; D004945:Esophagoscopy / Q000379:methods; D006801:Humans; D018613:Microscopy, Confocal; D009367:Neoplasm Staging; D011159:Population Surveillance; D012307:Risk Factors
Barrett's esophagus; advanced endoscopic imaging; chemoprevention; endoscopic eradication therapy; screening; surveillance