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Multinational survey on the preferred approach to management of Barrett’s esophagus in the Asia-Pacific region
BACKGROUND: Major societies provide differing guidance on management of Barrett’s esophagus (BE), making standardization challenging. AIM: To evaluate the preferred diagnosis and management practices of BE among Asian endoscopists. METHODS: Endoscopists from across Asia were invited to participate i...
Autores principales: | , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Baishideng Publishing Group Inc
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8040063/ https://www.ncbi.nlm.nih.gov/pubmed/33889279 http://dx.doi.org/10.4251/wjgo.v13.i4.279 |
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author | Kew, Guan Sen Soh, Alex Yu Sen Lee, Yeong Yeh Gotoda, Takuji Li, Yan-Qing Zhang, Yan Chan, Yiong Huak Siah, Kewin Tien Ho Tong, Daniel Law, Simon Ying Kit Ruszkiewicz, Andrew Tseng, Ping-Huei Lee, Yi-Chia Chang, Chi-Yang Quach, Duc Trong Kusano, Chika Bhatia, Shobna Wu, Justin Che-Yuen Singh, Rajvinder Sharma, Prateek Ho, Khek-Yu |
author_facet | Kew, Guan Sen Soh, Alex Yu Sen Lee, Yeong Yeh Gotoda, Takuji Li, Yan-Qing Zhang, Yan Chan, Yiong Huak Siah, Kewin Tien Ho Tong, Daniel Law, Simon Ying Kit Ruszkiewicz, Andrew Tseng, Ping-Huei Lee, Yi-Chia Chang, Chi-Yang Quach, Duc Trong Kusano, Chika Bhatia, Shobna Wu, Justin Che-Yuen Singh, Rajvinder Sharma, Prateek Ho, Khek-Yu |
author_sort | Kew, Guan Sen |
collection | PubMed |
description | BACKGROUND: Major societies provide differing guidance on management of Barrett’s esophagus (BE), making standardization challenging. AIM: To evaluate the preferred diagnosis and management practices of BE among Asian endoscopists. METHODS: Endoscopists from across Asia were invited to participate in an online questionnaire comprising eleven questions regarding diagnosis, surveillance and management of BE. RESULTS: Five hundred sixty-nine of 1016 (56.0%) respondents completed the survey, with most respondents from Japan (n = 310, 54.5%) and China (n = 129, 22.7%). Overall, the preferred endoscopic landmark of the esophagogastric junction was squamo-columnar junction (42.0%). Distal palisade vessels was preferred in Japan (59.0% vs 10.0%, P < 0.001) while outside Japan, squamo-columnar junction was preferred (59.5% vs 27.4%, P < 0.001). Only 16.3% of respondents used Prague C and M criteria all the time. It was never used by 46.1% of Japanese, whereas 84.2% outside Japan, endoscopists used it to varying extents (P < 0.001). Most Asian endoscopists (70.8%) would survey long-segment BE without dysplasia every two years. Adherence to Seattle protocol was poor with only 6.3% always performing it. 73.2% of Japanese never did it, compared to 19.3% outside Japan (P < 0.001). The most preferred (74.0%) treatment of non-dysplastic BE was proton pump inhibitor only when the patient was symptomatic or had esophagitis. For BE with low-grade dysplasia, 6-monthly surveillance was preferred in 61.9% within Japan vs 47.9% outside Japan (P < 0.001). CONCLUSION: Diagnosis and management of BE varied within Asia, with stark contrast between Japan and outside Japan. Most Asian endoscopists chose squamo-columnar junction to be the landmark for esophagogastric junction, which is incorrect. Most also did not consistently use Prague criteria, and Seattle protocol. Lack of standardization, education and research are possible reasons. |
format | Online Article Text |
id | pubmed-8040063 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
spelling | pubmed-80400632021-04-21 Multinational survey on the preferred approach to management of Barrett’s esophagus in the Asia-Pacific region Kew, Guan Sen Soh, Alex Yu Sen Lee, Yeong Yeh Gotoda, Takuji Li, Yan-Qing Zhang, Yan Chan, Yiong Huak Siah, Kewin Tien Ho Tong, Daniel Law, Simon Ying Kit Ruszkiewicz, Andrew Tseng, Ping-Huei Lee, Yi-Chia Chang, Chi-Yang Quach, Duc Trong Kusano, Chika Bhatia, Shobna Wu, Justin Che-Yuen Singh, Rajvinder Sharma, Prateek Ho, Khek-Yu World J Gastrointest Oncol Observational Study BACKGROUND: Major societies provide differing guidance on management of Barrett’s esophagus (BE), making standardization challenging. AIM: To evaluate the preferred diagnosis and management practices of BE among Asian endoscopists. METHODS: Endoscopists from across Asia were invited to participate in an online questionnaire comprising eleven questions regarding diagnosis, surveillance and management of BE. RESULTS: Five hundred sixty-nine of 1016 (56.0%) respondents completed the survey, with most respondents from Japan (n = 310, 54.5%) and China (n = 129, 22.7%). Overall, the preferred endoscopic landmark of the esophagogastric junction was squamo-columnar junction (42.0%). Distal palisade vessels was preferred in Japan (59.0% vs 10.0%, P < 0.001) while outside Japan, squamo-columnar junction was preferred (59.5% vs 27.4%, P < 0.001). Only 16.3% of respondents used Prague C and M criteria all the time. It was never used by 46.1% of Japanese, whereas 84.2% outside Japan, endoscopists used it to varying extents (P < 0.001). Most Asian endoscopists (70.8%) would survey long-segment BE without dysplasia every two years. Adherence to Seattle protocol was poor with only 6.3% always performing it. 73.2% of Japanese never did it, compared to 19.3% outside Japan (P < 0.001). The most preferred (74.0%) treatment of non-dysplastic BE was proton pump inhibitor only when the patient was symptomatic or had esophagitis. For BE with low-grade dysplasia, 6-monthly surveillance was preferred in 61.9% within Japan vs 47.9% outside Japan (P < 0.001). CONCLUSION: Diagnosis and management of BE varied within Asia, with stark contrast between Japan and outside Japan. Most Asian endoscopists chose squamo-columnar junction to be the landmark for esophagogastric junction, which is incorrect. Most also did not consistently use Prague criteria, and Seattle protocol. Lack of standardization, education and research are possible reasons. Baishideng Publishing Group Inc 2021-04-15 2021-04-15 /pmc/articles/PMC8040063/ /pubmed/33889279 http://dx.doi.org/10.4251/wjgo.v13.i4.279 Text en ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/ |
spellingShingle | Observational Study Kew, Guan Sen Soh, Alex Yu Sen Lee, Yeong Yeh Gotoda, Takuji Li, Yan-Qing Zhang, Yan Chan, Yiong Huak Siah, Kewin Tien Ho Tong, Daniel Law, Simon Ying Kit Ruszkiewicz, Andrew Tseng, Ping-Huei Lee, Yi-Chia Chang, Chi-Yang Quach, Duc Trong Kusano, Chika Bhatia, Shobna Wu, Justin Che-Yuen Singh, Rajvinder Sharma, Prateek Ho, Khek-Yu Multinational survey on the preferred approach to management of Barrett’s esophagus in the Asia-Pacific region |
title | Multinational survey on the preferred approach to management of Barrett’s esophagus in the Asia-Pacific region |
title_full | Multinational survey on the preferred approach to management of Barrett’s esophagus in the Asia-Pacific region |
title_fullStr | Multinational survey on the preferred approach to management of Barrett’s esophagus in the Asia-Pacific region |
title_full_unstemmed | Multinational survey on the preferred approach to management of Barrett’s esophagus in the Asia-Pacific region |
title_short | Multinational survey on the preferred approach to management of Barrett’s esophagus in the Asia-Pacific region |
title_sort | multinational survey on the preferred approach to management of barrett’s esophagus in the asia-pacific region |
topic | Observational Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8040063/ https://www.ncbi.nlm.nih.gov/pubmed/33889279 http://dx.doi.org/10.4251/wjgo.v13.i4.279 |
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