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Categorizing Risks within Barrett's Esophagus To Guide Surveillance and Interception; Suggesting a New Framework

Barrett's esophagus is a precancerous condition that can progress in a stepwise manner to dysplasia and eventually esophageal adenocarcinoma (EAC). Once diagnosed, patients with Barrett's esophagus are kept on surveillance to detect progression so that timely intervention can occur with en...

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Autores principales: Honing, Judith, Fitzgerald, Rebecca C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Association for Cancer Research 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10234311/
https://www.ncbi.nlm.nih.gov/pubmed/37259801
http://dx.doi.org/10.1158/1940-6207.CAPR-22-0447
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author Honing, Judith
Fitzgerald, Rebecca C.
author_facet Honing, Judith
Fitzgerald, Rebecca C.
author_sort Honing, Judith
collection PubMed
description Barrett's esophagus is a precancerous condition that can progress in a stepwise manner to dysplasia and eventually esophageal adenocarcinoma (EAC). Once diagnosed, patients with Barrett's esophagus are kept on surveillance to detect progression so that timely intervention can occur with endoscopic therapy. Several demographic and clinical risk factors are known to increase progression toward EAC, such as longer Barrett's segments, and these patients are kept on tighter surveillance. While p53 IHC has been advocated as an adjunct to histopathologic diagnosis, use of this biomarker is variable, and no other molecular factors are currently applied. Given the new evidence available, it is time to consider whether other risk factors or tools could be applied in clinical practice to decide on closer or attenuated surveillance. In this commentary, we summarize the most relevant risk factors for Barrett's esophagus progression, highlight the most promising novel risk stratification tools—including nonendoscopic triage and commercial biomarker panels, and propose a new framework suggesting how to incorporate risk stratification into clinical practice.
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spelling pubmed-102343112023-06-02 Categorizing Risks within Barrett's Esophagus To Guide Surveillance and Interception; Suggesting a New Framework Honing, Judith Fitzgerald, Rebecca C. Cancer Prev Res (Phila) Commentary Barrett's esophagus is a precancerous condition that can progress in a stepwise manner to dysplasia and eventually esophageal adenocarcinoma (EAC). Once diagnosed, patients with Barrett's esophagus are kept on surveillance to detect progression so that timely intervention can occur with endoscopic therapy. Several demographic and clinical risk factors are known to increase progression toward EAC, such as longer Barrett's segments, and these patients are kept on tighter surveillance. While p53 IHC has been advocated as an adjunct to histopathologic diagnosis, use of this biomarker is variable, and no other molecular factors are currently applied. Given the new evidence available, it is time to consider whether other risk factors or tools could be applied in clinical practice to decide on closer or attenuated surveillance. In this commentary, we summarize the most relevant risk factors for Barrett's esophagus progression, highlight the most promising novel risk stratification tools—including nonendoscopic triage and commercial biomarker panels, and propose a new framework suggesting how to incorporate risk stratification into clinical practice. American Association for Cancer Research 2023-06-01 2023-06-01 /pmc/articles/PMC10234311/ /pubmed/37259801 http://dx.doi.org/10.1158/1940-6207.CAPR-22-0447 Text en ©2023 The Authors; Published by the American Association for Cancer Research https://creativecommons.org/licenses/by-nc-nd/4.0/This open access article is distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) license.
spellingShingle Commentary
Honing, Judith
Fitzgerald, Rebecca C.
Categorizing Risks within Barrett's Esophagus To Guide Surveillance and Interception; Suggesting a New Framework
title Categorizing Risks within Barrett's Esophagus To Guide Surveillance and Interception; Suggesting a New Framework
title_full Categorizing Risks within Barrett's Esophagus To Guide Surveillance and Interception; Suggesting a New Framework
title_fullStr Categorizing Risks within Barrett's Esophagus To Guide Surveillance and Interception; Suggesting a New Framework
title_full_unstemmed Categorizing Risks within Barrett's Esophagus To Guide Surveillance and Interception; Suggesting a New Framework
title_short Categorizing Risks within Barrett's Esophagus To Guide Surveillance and Interception; Suggesting a New Framework
title_sort categorizing risks within barrett's esophagus to guide surveillance and interception; suggesting a new framework
topic Commentary
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10234311/
https://www.ncbi.nlm.nih.gov/pubmed/37259801
http://dx.doi.org/10.1158/1940-6207.CAPR-22-0447
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