scholarly journals Chemoprevention in Barrett’s esophagus and esophageal adenocarcinoma

2021 ◽  
Vol 14 ◽  
pp. 175628482110337
Author(s):  
Motasem Alkhayyat ◽  
Prabhat Kumar ◽  
Krishna O. Sanaka ◽  
Prashanthi N. Thota
Keyword(s):  
Barrett’S Esophagus ◽  
Esophageal Adenocarcinoma ◽  
Barrett's Esophagus ◽  
Controlled Trial ◽  
Early Esophageal Cancer ◽  
Substantial Impact ◽  
Randomized Controlled ◽  
The Past ◽  
Incidence Of Cancer ◽  
Screening And Surveillance

There has been a dramatic increase in the incidence of Barrett’s esophagus and esophageal adenocarcinoma over the past several decades with a continued rise expected in the future. Several strategies have been developed for screening and surveillance of patients with Barrett’s esophagus and endoscopic treatment of Barrett’s associated dysplasia and early esophageal cancer; however, they have not made a substantial impact on the incidence of cancer. Herein, chemoprevention becomes an attractive idea for reducing the incidence of cancer in Barrett’s patients. Several agents appear promising in preclinical and observational studies but very few have been evaluated in randomized controlled trials. Strongest evidence to date is available for proton-pump inhibitors and Aspirin that have been evaluated in a large randomized controlled trial. Other agents such as statins, metformin, ursodeoxycholic acid, and dietary supplements have insufficient evidence for chemoprevention in Barrett’s patients.

Evaluation of Barrett's Esophagus

2021 ◽  
Author(s):  
Trent Walradt ◽  
Mohammad Bilal ◽  
Douglas K. Pleskow
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Barrett’S Esophagus ◽  
Esophageal Adenocarcinoma ◽  
Reflux Disease ◽  
Barrett's Esophagus ◽  
Squamous Epithelium ◽  
The Past ◽  
Screening And Surveillance ◽  
Stratified Squamous Epithelium

AbstractBarrett's esophagus (BE) is the condition in which a metaplastic columnar epithelium that is predisposed to malignancy replaces the stratified squamous epithelium that normally lines the distal esophagus. BE develops as a consequence of chronic gastroesophageal reflux disease and predisposes to esophageal adenocarcinoma (EAC). Several societal guidelines recommend screening and surveillance for BE to reduce the risk of EAC and its related morbidity and mortality. Even among persons undergoing screening and surveillance, a substantial proportion of cases of EAC can be missed. Consequently, the armamentarium for the evaluation of BE has expanded rapidly over the past decade. In this article, we summarize the pathophysiology and diagnosis of BE. We also discuss the latest advancements in the evaluation of BE.

scholarly journals Implications of Recent Revelations from Basic and Clinical Studies of Barrett’s Esophagus for Screening and Surveillance Strategies

2021 ◽  
Vol 1 (1) ◽  
pp. 86-92
Author(s):  
Stuart Jon Spechler ◽  
Rhonda F. Souza
Keyword(s):  
High Risk ◽  
Barrett’S Esophagus ◽  
Barrett's Esophagus ◽  
Prevention Strategies ◽  
Endoscopic Screening ◽  
Screening Practices ◽  
The Past ◽  
Screening And Surveillance ◽  
Gerd Symptoms ◽  
Current Screening

During the past several decades, while the incidence of esophageal adenocarcinoma (EAC) has risen dramatically, our primary EAC-prevention strategies have been endoscopic screening of individuals with GERD symptoms for Barrett’s esophagus (BE), and endoscopic surveillance for those found to have BE. Unfortunately, current screening practices have failed to identify most patients who develop EAC, and the efficacy of surveillance remains highly questionable. We review potential reasons for failure of these practices including recent evidence that most EACs develop through a rapid genomic doubling pathway, and recent data suggesting that many EACs develop from segments of esophageal intestinal metaplasia too short to be recognized as BE. We highlight need for a biomarker to identify BE patients at high risk for neoplasia (who would benefit from early therapeutic intervention), and BE patients at low risk (who would not benefit from surveillance). Promising recent efforts to identify such a biomarker are reviewed herein.

scholarly journals Incidence of Dysplasia in Patients with Barrett’s Esophagus

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
H A Elakkad ◽  
A M M Elhefny ◽  
M A Alsayed ◽  
K W Shawky
Keyword(s):  
Risk Factors ◽  
Barrett’S Esophagus ◽  
Esophageal Adenocarcinoma ◽  
Barrett's Esophagus ◽  
Inclusion Criteria ◽  
Upper Gi ◽  
The Past ◽  
History Of ◽  
Upper Gi Endoscopy ◽  
Malignant Condition

Abstract Background Barrett’s esophagus is a condition which predisposes towards development of dysplasia and finally towards esophageal adenocarcinoma, a highly lethal tumour which has been increasing in incidence over the past three decades. Although BE is the single best identified risk factor for the development of esophageal adenocarcinoma, yet the overwhelming majority of Barrett’s patients will never develop this cancer. Objective To evaluate the incidence of dysplasia in patients with BE regarding risk factors such as gender, smoking, obesity, patient’s age, duration of reflux, treatment received, associated disease as DM and esophageal histopathology. Patients and Methods The study was conducted on 30 patients previously diagnosed with BE. The patients were selected according to some inclusion criteria such as being diagnosed by upper GI endoscopy and a biopsy was taken. Patients with history of previous anti-reflux surgery were excluded. Results A strong correlation was found between the incidence of dysplasia and male gender, mean age 58.17 years, smoking, DM, hiatus hernia and esophagitis. Conclusion As the incidence of dysplasia and esophageal adenocarcinoma continues to rise at an alarming rate, widespread endoscopic surveillance of Barrett’s esophagus patients is performed in order to detect any abnormality at an earlier and potentially curable stage. In addition to highlighting the risk factors that aggravates this pre-malignant condition.

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