Esophageal cancer screening: Difference between revisions

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*The predominant type of esophageal cancer in the United States is [[adenocarcinoma]].  
*The predominant type of esophageal cancer in the United States is [[adenocarcinoma]].  
*Under current guidelines, random endoscopic [[Biopsy|biopsies]] are taken in all 4 quadrants with a high resolution [[Endoscopy|endoscope]].  
*Under current guidelines, random endoscopic [[Biopsy|biopsies]] are taken in all 4 quadrants with a high resolution [[Endoscopy|endoscope]].  
*[[Dysplasia]] within lesions of the [[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.  
*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 are found in white men that are older than 50 years of age.  
*Most dysplastic changes are found in white men that are older than 50 years of age.  
Line 18: Line 17:
===Squamous cell carcinoma screening===
===Squamous cell carcinoma screening===


*Since squamous cell carcinoma of the esophagus is prevalent more in underdeveloped countries, there is no reliable data to suggest that screening programs are effective when implemented.  
*Since squamous cell carcinoma of the esophagus is more prevalent in underdeveloped countries, there is no reliable data to suggest that screening programs are effective when implemented.  
*However, in China, esophageal cancer is the sixth most common cancer and the fourth most common cause of death from cancer.
*However, in China, esophageal cancer is the sixth most common cancer and the fourth most common cause of death from cancer.
*In China, 287,000 new cases of esophageal squamous cell carcinoma and 211,000 deaths were reported in 2012.
*A screening program in a high risk population was put into effect where those with mild to moderate dysplasia are examined via endoscopy every 3 years, whilst those with severe dysplasia were screened once per year.  
*A screening program in a high risk population was put into effect where those with mild to moderate dysplasia are examined via endoscopy every 3 years, whilst those with severe dysplasia were screened once per year.  
*The patients were concomitantly treated with monoclonal antibodies for the next three years, and the incidence decreased by 57%.
*The patients were concomitantly treated with monoclonal antibodies for the next three years, and the incidence decreased by 57%.

Revision as of 13:13, 18 December 2017

Esophageal cancer Microchapters

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Differentiating Esophageal cancer from other Diseases

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Risk calculators and risk factors for Esophageal cancer screening

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 in 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.
  • 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 are found in white men that are older than 50 years of age.
  • One study surmised 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.[1]

Squamous cell carcinoma screening

  • Since squamous cell carcinoma of the esophagus is more prevalent in underdeveloped countries, there is no reliable data to suggest that screening programs are effective when implemented.
  • However, in China, esophageal cancer is the sixth most common cancer and the fourth most common cause of death from cancer.
  • A screening program in a high risk population was put into effect where those with mild to moderate dysplasia are examined via endoscopy every 3 years, whilst those with severe dysplasia were screened once per year.
  • The patients were concomitantly treated with monoclonal antibodies for the next three years, and the incidence decreased by 57%.
  • These results demonstrated that the screening for esophageal squamous cell carcinoma is effective in the prevention of esophageal cancer.[2]

References

  1. Domper Arnal MJ, Ferrández Arenas Á, Lanas Arbeloa Á (2015). "Esophageal cancer: Risk factors, screening and endoscopic treatment in Western and Eastern countries". World J. Gastroenterol. 21 (26): 7933–43. doi:10.3748/wjg.v21.i26.7933. PMC 4499337. PMID 26185366.
  2. Lin PZ, Zhang JS, Cao SG, Rong ZP, Gao RQ, Han R, Shu SP (1988). "[Secondary prevention of esophageal cancer--intervention on precancerous lesions of the esophagus]". Zhonghua Zhong Liu Za Zhi (in Chinese). 10 (3): 161–6. PMID 3219974.


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