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*[[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>.  
*[[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]].  
*After [[diagnosis]], regular surveillance is needed based on the grade of [[dysplasia]].  
*[[Strong]] [[recommendation]], low-quality [[evidence]] [[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>  
*[[Strong]] recommendation, low-quality [[evidence]] 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>  


[[Weak]] [[recommendation]], moderate-quality [[evidence]]: [[Endoscopic]] [[surveillance]] in [[patients]] [[with]] [[Barrett's esophagus]]
Weak recommendation, moderate-quality [[evidence]]: [[Endoscopic]] surveillance in [[patients]] with [[Barrett's esophagus]]
The [[following]] [[intervals]] are [[recommended]]:
The following intervals are recommended:
* No [[dysplasia]]: 3–5 [[years]].
* No [[dysplasia]]: 3–5 years.
* Low-grade [[dysplasia]]: 6–12 [[months]].
* 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>
* 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>


==References==
==References==

Revision as of 16:09, 6 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. Weak recommendation, moderate-quality evidence: screening in patients with multiple risk factors for esophageal adenocarcinoma: Age > 50 years old, male, white, chronic GERD, hiatal hernia, elevated BMI (body mass index), and intra-abdominal distribution of body fat. Strong recommendation, low-quality evidence against screening general population with GERD and no risk factors.

Screening

Weak recommendation, moderate-quality evidence: Endoscopic surveillance in patients with Barrett's esophagus The following intervals are recommended:

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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