Barrett’s Oesophagus: Today’s Mistake and Tomorrow’s Wisdom in Screening and Prevention

Tan W.K.a,b,c· di Pietro M.a,b

Author affiliations

aMRC Cancer Unit, University of Cambridge, Cambridge, United Kingdom
bDepartment of Gastroenterology, Addenbrookes Hospital, Cambridge University NHS Foundation Trust, Cambridge, United Kingdom
cDeparment of Gastroenterology and Hepatology, Hinchingbrooke Hospital, North West Anglia NHS Foundation Trust, Huntingdon, United Kingdom

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Article / Publication Details

First-Page Preview

Abstract of Review Article

Received: October 23, 2021
Accepted: January 10, 2022
Published online: February 25, 2022

Number of Print Pages: 7
Number of Figures: 0
Number of Tables: 3

ISSN: 2297-4725 (Print)
eISSN: 2297-475X (Online)

For additional information: https://www.karger.com/VIS

Abstract

Background: Oesophageal adenocarcinoma (OAC) is a lethal cancer with an overall 5-year survival of <20%. Given the presence of a pre-invasive disease stage, also known as Barrett’s oesophagus (BO), and the availability of minimally invasive treatments for BO-related neoplasia, it is thought that early detection is the best strategy to improve patient outcomes. Clinical guidelines recommend endoscopic screening in patients with symptoms of acid reflux and additional risk factors. This strategy is flawed by the cost and invasiveness of endoscopy as well as by the fact that a significant proportion of OAC patients deny a history of reflux symptoms. Summary: New research on the use of epidemiologic and clinical data has allowed the creation of risk-prediction algorithms to identify the population at risk. In addition, newer less-invasive devices such as transnasal endoscopy, Cytosponge, volumetric laser endomicroscopy, and volatile organic compounds are emerging as promising options to allow screening in the primary care setting. Finally, there is an opportunity to intervene at the pre-invasive stage with pharmacological strategies to reduce the risk burden. Key Messages: In this review, we provide a critical appraisal of the different screening approaches and chemopreventive strategies and a guide to readers on how to implement research evidence in clinical practice.

© 2022 S. Karger AG, Basel

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First-Page Preview

Abstract of Review Article

Received: October 23, 2021
Accepted: January 10, 2022
Published online: February 25, 2022

Number of Print Pages: 7
Number of Figures: 0
Number of Tables: 3

ISSN: 2297-4725 (Print)
eISSN: 2297-475X (Online)

For additional information: https://www.karger.com/VIS

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