THURSDAY, June 16 (HealthDay News) -- The risk of cancer
associated with the condition known as Barrett's esophagus may be
lower than previously thought, according to a new long-term
study.
People diagnosed with the premalignant condition are advised to
undergo routine endoscopies to screen for esophageal
adenocarcinoma, a common form of esophageal cancer. Endoscopy
involves insertion of a long, thin tube with a camera at the end
into the esophagus, enabling doctors to check for
abnormalities.
In conducting the study, published online June 16 in the
Journal of the National Cancer Institute, researchers in Northern Ireland followed more than 8,500 patients diagnosed with Barrett's esophagus.
During a follow-up period averaging seven years, 79 of the
patients were diagnosed with esophageal cancer. Cancer of the
gastric cardia (the part of the stomach closest to the esophagus)
was diagnosed in another 16 participants, and 36 developed
precancerous changes known as high-grade dysplasia.
Overall, the combined incidence rate for these three conditions
was 0.22 percent per year -- much lower than the 0.58 percent and 3
percent annual rates of cancer reported in prior studies, the
authors said in a journal news release.
The findings suggest the recommended routine cancer screenings
among Barrett's esophagus patients are based on inflated estimates
of cancer risk and may not be necessary, they said.
One U.S. expert called the findings "important."
"It emphasizes the need to not only identify those with who have Barrett's esophagus but also to then identify those who will go on to possibly develop cancer, since most will not. We can then create a more selective approach to the 1 to 2 percent of Americans who have Barrett's, said Dr. Sharmila Anandasabapathy, an associate professor of medicine and gastroenterology, and medical director of endoscopy at Mount Sinai Medical Center in New York City.
The study also found that people aged 60 to 69 were at greater
risk for cancer than patients under 50 or older than 80, and that
men were more likely than women to progress to cancer.
"The study underscores the fact that white men over 50 are the 'bulls eye' high risk group for the development of esophageal cancer and should be screened annually," noted another expert, Dr Jonathan E. Aviv, clinical director of the Voice and Swallowing Center at ENT and Allergy Associates in New York City.
Dr. Douglas Corley, of Kaiser Permanente's research division in
Oakland, Calif., and author of an accompanying editorial, added in
the news release that the study could "help inform the development
of more meaningful personalized risk scores that incorporate
demographic, biochemical, and genetic factors."
More information
The U.S. National Digestive Diseases Information Clearinghouse
provides more information on
Barrett's esophagus.