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Review on the Annual Cancer Risk of Barrett's Esophagus in Persons with Symptoms of Gastroesophageal Reflux Disease.
MedLine Citation:
PMID:  23225453     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND: Esophageal adenocarcinoma results from gastroesophageal reflux and develops along a sequence involving non-dysplastic Barrett's esophagus (NDBE), low- (LGD) and high-grade dysplasia (HGD). We aimed to examine the reported annual cancer risk for NDBE in persons with symptoms of gastroesophageal reflux disease, i.e. symptomatic NDBE.
MATERIALS AND METHODS: Our study reviewed seven population-based studies and five meta-analyses on the annual cancer risk of symptomatic NDBE published between 2006-2012.
RESULTS: The published annual cancer risk of symptomatic NDBE ranges from 0.12-0.5% and 0.33-0.7% in population-based studies and meta-analyses, respectively. Risk factors for cancer development include male gender, age >60 years, length of endoscopically visible columnar lined esophagus (CLE) >3.0 cm, size of the hiatal hernia, progression to LGD/HGD and past history of cigarette smoking. The mean time-to-cancer development is 5 years and ranges from 2 to 15 years. Age at the diagnosis of symptomatic NDBE and cancer development plateaus around 50 and 60 years of age, respectively. Symptomatic NDBE does not affect the life expectancy, when compared to the general population. The majority of patients with NDBE do not die due to esophageal adenocarcinoma but due to comorbidity (cardiorespiratory, neurological, other cancer). The risk and prognosis of asymptomatic NDBE remains unknown.
CONCLUSION: The published annual cancer risk for symptomatic NDBE is low. However, demographic and endoscopic data contribute to define a subgroup of patients with symptomatic NDBE with a cancer risk comparable to LGD, where elimination within controlled trials seems justified (radiofrequency ablation). Future efforts should extend towards asymptomatic NDBE, the major cause for cancer development.
Johannes Lenglinger; Martin Riegler; Enrico Cosentini; Reza Asari; Ildiko Mesteri; Fritz Wrba; Sebastian F Schoppmann
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Anticancer research     Volume:  32     ISSN:  1791-7530     ISO Abbreviation:  Anticancer Res.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8102988     Medline TA:  Anticancer Res     Country:  Greece    
Other Details:
Languages:  eng     Pagination:  5465-73     Citation Subset:  IM    
University Clinic of Surgery, Comprehensive Cancer Center Vienna Medical University Vienna, Vienna General Hospital, Währinger Gürtel 18-20, A-1090 Vienna, Austria.
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