Barrett's esophagus screening: Difference between revisions

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==Overview==
==Overview==


[[Barret's esophagus]] is a [[major]] [[risk factor]] for [[development]] of [[esophageal]] [[adenocarcinoma]]. [[After]] [[diagnosis]], [[regular]] [[surveillance]] is [[needed]] [[based]] on the [[grade]] of [[dyaplasia]].  
[[Barrett's esophagus]] is a major [[risk factor]] for [[development]] of [[esophageal]] [[adenocarcinoma]]. After [[diagnosis]], regular surveillance is needed based on the grade of dysplasia. Screening for barrett's esophagus is strongly recommended with multiple [[risk factors]] for [[esophageal]] [[adenocarcinoma]] include: [[Age]] > 50 years old, [[male]], white, chronic [[GERD]], [[hiatal hernia]], elevated [[BMI]] (body mass index), and intra-abdominal distribution of [[body]] [[fat]]. Screening is weakly recommended in general [[population]] with [[GERD]] and no [[risk factors]].
 
* [[Weak]] [[recommendation]], [[moderate]]-[[quality]] [[evidence]]: [[screening]] in [[patients]] with [[multiple]] [[risk factors]] for [[esophageal]] [[adenocarcinoma]]:
# [[Age]] : > 50 years old
# [[Sex]] : [[male]]
# [[Race]]: [[white]]
# Other: chronic [[GERD]], [[hiatal hernia]], [[elevated]] [[BMI]] (body mass index),and [[intraabdominal]] [[distribution]] of [[body]] [[fat]].
* [[Strong]] [[recommendation]], low-quality [[evidence]]:
# [[Recommend]] [[against]] [[screening]] [[general]] [[population]] [[with]] [[GERD]] and no [[risk factors]].<ref name="pmid21376940">{{cite journal |author=Spechler SJ, Sharma P, Souza RF, Inadomi JM, Shaheen NJ |title=American Gastroenterological Association medical position statement on the management of Barrett's esophagus |journal=Gastroenterology |volume=140 |issue=3 |pages=1084–91 |year=2011 |month=March |}}</ref>
 
 
There is insufficient evidence to recommend routine screening for [disease/malignancy].
 
OR
 
According to the [guideline name], screening for [disease name] is not recommended.
 
OR
 
According to the [guideline name], screening for [disease name] by [test 1] is recommended every [duration] among patients with [condition 1], [condition 2], and [condition 3].
 
==Screening==
[[Weak]] [[recommendation]], moderate-quality [[evidence]]: [[Endoscopic]] [[surveillance]] in [[patients]] [[with]] [[Barrett's esophagus]]
The [[following]] [[intervals]] are [[recommended]]:
* No [[dysplasia]]: 3–5 [[years]].
* Low-grade [[dysplasia]]: 6–12 [[months]].
 
* High-grade [[dysplasia]] in the [[absence]] of [[eradication]] [[therapy]]: 3 months.<ref name="pmid21376940">{{cite journal |author=Spechler SJ, Sharma P, Souza RF, Inadomi JM, Shaheen NJ |title=American Gastroenterological Association medical position statement on the management of Barrett's esophagus |journal=Gastroenterology |volume=140 |issue=3 |pages=1084–91 |year=2011 |month=March |pmid=21376940 |doi=10.1053/j.gastro.2011.01.030 |url=}}</ref>


==Screening==
==Screening==
[[Barrett's esophagus]] is a major [[risk factor]] for [[development]] of [[esophageal]] [[adenocarcinoma]].<ref name="pmid9040193">{{cite journal| author=Drewitz DJ, Sampliner RE, Garewal HS| title=The incidence of adenocarcinoma in Barrett's esophagus: a prospective study of 170 patients followed 4.8 years. | journal=Am J Gastroenterol | year= 1997 | volume= 92 | issue= 2 | pages= 212-5 | pmid=9040193 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9040193  }} </ref><ref name="pmid11448658">{{cite journal| author=Eckardt VF, Kanzler G, Bernhard G| title=Life expectancy and cancer risk in patients with Barrett's esophagus: a prospective controlled investigation. | journal=Am J Med | year= 2001 | volume= 111 | issue= 1 | pages= 33-7 | pmid=11448658 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11448658  }} </ref><ref name="pmid18045592">{{cite journal| author=Rastogi A, Puli S, El-Serag HB, Bansal A, Wani S, Sharma P| title=Incidence of esophageal adenocarcinoma in patients with Barrett's esophagus and high-grade dysplasia: a meta-analysis. | journal=Gastrointest Endosc | year= 2008 | volume= 67 | issue= 3 | pages= 394-8 | pmid=18045592 | doi=10.1016/j.gie.2007.07.019 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18045592  }} </ref><ref name="pmid16630761">{{cite journal| author=Sharma P, Falk GW, Weston AP, Reker D, Johnston M, Sampliner RE| title=Dysplasia and cancer in a large multicenter cohort of patients with Barrett's esophagus. | journal=Clin Gastroenterol Hepatol | year= 2006 | volume= 4 | issue= 5 | pages= 566-72 | pmid=16630761 | doi=10.1016/j.cgh.2006.03.001 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16630761  }} </ref><ref name="pmid21997553">{{cite journal| author=Desai TK, Krishnan K, Samala N, Singh J, Cluley J, Perla S et al.| title=The incidence of oesophageal adenocarcinoma in non-dysplastic Barrett's oesophagus: a meta-analysis. | journal=Gut | year= 2012 | volume= 61 | issue= 7 | pages= 970-6 | pmid=21997553 | doi=10.1136/gutjnl-2011-300730 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21997553  }} </ref> After [[diagnosis]], regular surveillance is needed based on the grade of [[dysplasia]].


*There is insufficient evidence to recommend routine screening for [disease/malignancy].
Screening for barrett's esophagus is strongly recommended in:
OR
* [[Age]] > 50 years old
*According to the [guideline name], screening for [disease name] is not recommended.
* [[male]]
OR
* White
*According to the [guideline name], screening for [disease name] by [test 1] is recommended every [duration] among patients with:
* Chronic [[GERD]]
**[Condition 1]
* [[hiatal hernia]]
**[Condition 2]
* Elevated [[BMI]] (body mass index)
**[Condition 3]
* Intra-abdominal distribution of [[body]] [[fat]]<ref name="pmid21376940">{{cite journal |author=Spechler SJ, Sharma P, Souza RF, Inadomi JM, Shaheen NJ |title=American Gastroenterological Association medical position statement on the management of Barrett's esophagus |journal=Gastroenterology |volume=140 |issue=3 |pages=1084–91 |year=2011 |month=March |}}</ref>
Screening is weakly recommended due to moderate-quality [[evidence]]:<ref name="pmid21376940" />
* [[Endoscopic]] surveillance in [[patients]] with [[Barrett's esophagus]] is recommended within the following intervals:
** No [[dysplasia]]: 3–5 years
** Low-grade [[dysplasia]]: 6–12 months
** High-grade [[dysplasia]] in the absence of eradication [[therapy]]: 3 months


==References==
==References==

Latest revision as of 17:22, 21 February 2018

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

Overview

Barrett's esophagus is a major risk factor for development of esophageal adenocarcinoma. After diagnosis, regular surveillance is needed based on the grade of dysplasia. Screening for barrett's esophagus is strongly recommended with multiple risk factors for esophageal adenocarcinoma include: Age > 50 years old, male, white, chronic GERD, hiatal hernia, elevated BMI (body mass index), and intra-abdominal distribution of body fat. Screening is weakly recommended in general population with GERD and no risk factors.

Screening

Barrett's esophagus is a major risk factor for development of esophageal adenocarcinoma.[1][2][3][4][5] After diagnosis, regular surveillance is needed based on the grade of dysplasia.

Screening for barrett's esophagus is strongly recommended in:

Screening is weakly recommended due to moderate-quality evidence:[6]

References

  1. ↑ Drewitz DJ, Sampliner RE, Garewal HS (1997). "The incidence of adenocarcinoma in Barrett's esophagus: a prospective study of 170 patients followed 4.8 years". Am J Gastroenterol. 92 (2): 212–5. PMID 9040193.
  2. ↑ Eckardt VF, Kanzler G, Bernhard G (2001). "Life expectancy and cancer risk in patients with Barrett's esophagus: a prospective controlled investigation". Am J Med. 111 (1): 33–7. PMID 11448658.
  3. ↑ Rastogi A, Puli S, El-Serag HB, Bansal A, Wani S, Sharma P (2008). "Incidence of esophageal adenocarcinoma in patients with Barrett's esophagus and high-grade dysplasia: a meta-analysis". Gastrointest Endosc. 67 (3): 394–8. doi:10.1016/j.gie.2007.07.019. PMID 18045592.
  4. ↑ Sharma P, Falk GW, Weston AP, Reker D, Johnston M, Sampliner RE (2006). "Dysplasia and cancer in a large multicenter cohort of patients with Barrett's esophagus". Clin Gastroenterol Hepatol. 4 (5): 566–72. doi:10.1016/j.cgh.2006.03.001. PMID 16630761.
  5. ↑ Desai TK, Krishnan K, Samala N, Singh J, Cluley J, Perla S; et al. (2012). "The incidence of oesophageal adenocarcinoma in non-dysplastic Barrett's oesophagus: a meta-analysis". Gut. 61 (7): 970–6. doi:10.1136/gutjnl-2011-300730. PMID 21997553.
  6. ↑ 6.0 6.1 Spechler SJ, Sharma P, Souza RF, Inadomi JM, Shaheen NJ (2011). "American Gastroenterological Association medical position statement on the management of Barrett's esophagus". Gastroenterology. 140 (3): 1084–91. Unknown parameter |month= ignored (help)

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