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Barrett’s Esophagus and Cancer Risk: How Research Advances Can Impact Clinical Practice

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 clin...

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Autores principales: di Pietro, Massimiliano, Alzoubaidi, Durayd, Fitzgerald, Rebecca C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Gut and Liver 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4113043/
https://www.ncbi.nlm.nih.gov/pubmed/25071900
http://dx.doi.org/10.5009/gnl.2014.8.4.356
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author di Pietro, Massimiliano
Alzoubaidi, Durayd
Fitzgerald, Rebecca C.
author_facet di Pietro, Massimiliano
Alzoubaidi, Durayd
Fitzgerald, Rebecca C.
author_sort di Pietro, Massimiliano
collection PubMed
description 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.
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spelling pubmed-41130432014-07-28 Barrett’s Esophagus and Cancer Risk: How Research Advances Can Impact Clinical Practice di Pietro, Massimiliano Alzoubaidi, Durayd Fitzgerald, Rebecca C. Gut Liver Review 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. Gut and Liver 2014-07 2014-07-01 /pmc/articles/PMC4113043/ /pubmed/25071900 http://dx.doi.org/10.5009/gnl.2014.8.4.356 Text en Copyright © 2014 by The Korean Society of Gastroenterology, the Korean Society of Gastrointestinal Endoscopy, the Korean Society of Neurogastroenterology and Motility, Korean College of Helicobacter and Upper Gastrointestinal Research, Korean Association for the Study of Intestinal Diseases, the Korean Association for the Study of the Liver, Korean Pancreatobiliary Association, and Korean Society of Gastrointestinal Cancer. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review
di Pietro, Massimiliano
Alzoubaidi, Durayd
Fitzgerald, Rebecca C.
Barrett’s Esophagus and Cancer Risk: How Research Advances Can Impact Clinical Practice
title Barrett’s Esophagus and Cancer Risk: How Research Advances Can Impact Clinical Practice
title_full Barrett’s Esophagus and Cancer Risk: How Research Advances Can Impact Clinical Practice
title_fullStr Barrett’s Esophagus and Cancer Risk: How Research Advances Can Impact Clinical Practice
title_full_unstemmed Barrett’s Esophagus and Cancer Risk: How Research Advances Can Impact Clinical Practice
title_short Barrett’s Esophagus and Cancer Risk: How Research Advances Can Impact Clinical Practice
title_sort barrett’s esophagus and cancer risk: how research advances can impact clinical practice
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4113043/
https://www.ncbi.nlm.nih.gov/pubmed/25071900
http://dx.doi.org/10.5009/gnl.2014.8.4.356
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