Esophageal cancer screening: Difference between revisions

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Revision as of 15:51, 11 December 2017

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]

Overview

Screening may be effective in reducing the incidence of esophageal cancer, especially with Barrett's esophagus-associated adenocarcinoma, however, not very cost effective.

Screening

Adenocarcinoma screening

The predominant type of esophageal cancer in the United States is adenocarcinoma.
Under current guidelines, random endoscopic biopsies are taken in all 4 quadrants with a high resolution endoscope.
Dysplasia within lesions of Barrett's esophagus indicates a marked increase in cancer risk.
It should be noted that those who presented with adenocarcinoma demonstrated no prior Barrett's esophagus in 80 - 90% of the time.
Most dysplastic changes were found in 50 year old white men.
In one study, the authors concluded that the only cost-effective strategy was once in a lifetime screening of 50-year-old white men with GERD, followed by surveillance of those with dysplasia only.

Squamous cell carcinoma screening

Since this type of esophageal cancer exists in the more underdeveloped countries, there is no reliable data to suggest that screening programs exist or that they are effective when implemented. However, it has been suggested that screening high risk populations may be of benefit in reducing the incidence of esophageal cancer.

References

Template:WikiDoc Sources

@@ Line 3: / Line 3: @@
 ==Overview==
-Screening may be effective in reducing the incidence of esophageal cancer, especially with Barrett's esophagus-associated adenocarcinoma.
+Screening may be effective in reducing the incidence of esophageal cancer, especially with Barrett's esophagus-associated adenocarcinoma, however, not very cost effective.
 ==Screening==
-According to current guidelines, random endoscopic biopsies should be taken in all 4 quadrants and each 2 cm of columnar epithelium, and ideally performed with high-resolution endoscopes and NBI (narrow banding imaging).Dysplasia within BE lesions signals a marked increase in cancer risk: the annual risk is approximately 1% for patients with low-grade dysplasia and more than 5% for patients with high-grade dysplasia. However, 80% to 90% of cases of esophageal adenocarcinoma are diagnosed in patients without known BE. Endoscopic screening results in detection of BE in 6% to 12% of patients with prolonged GERD symptoms, most frequently white men older than 50 years of age
+===Adenocarcinoma screening===
-Dysplasia within BE lesions signals a marked increase in cancer risk: the annual risk is approximately 1% for patients with low-grade dysplasia and more than 5% for patients with high-grade dysplasia. However, 80% to 90% of cases of esophageal adenocarcinoma are diagnosed in patients without known BE. Endoscopic screening results in detection of BE in 6% to 12% of patients with prolonged GERD symptoms, most frequently white men older than 50 years of age
+*The predominant type of esophageal cancer in the United States is adenocarcinoma.
+*Under current guidelines, random endoscopic biopsies are taken in all 4 quadrants with a high resolution endoscope.
+*Dysplasia within lesions of Barrett's esophagus indicates a marked increase in cancer risk.
+*It should be noted that those who presented with adenocarcinoma demonstrated no  prior Barrett's esophagus in 80 - 90% of the time.
+*Most dysplastic changes were found in 50 year old white men.
+*In one study, the authors concluded that the only cost-effective strategy was once in a lifetime screening of 50-year-old white men with GERD, followed by surveillance of those with dysplasia only.
-In one study, the authors concluded that the only cost-effective strategy was once in a lifetime screening of 50-year-old white men with GERD, followed by surveillance of those with dysplasia only.
+===Squamous cell carcinoma screening===
+Since this type of esophageal cancer exists in the more underdeveloped countries, there is no reliable data to suggest that screening programs exist or that they are effective when implemented. However, it has been suggested that screening high risk populations may be of benefit in reducing the incidence of esophageal cancer.
 ==References==
 {{reflist|2}}