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==Screening==
==Screening==
*There is no program in effect to screen for esophageal cancer at present, however the benefits of screening were demonstrated in a high risk population in China that showed a reduction in the incidence of esophageal cancer by 53%.<ref name="pmid3219974">{{cite journal |vauthors=Lin PZ, Zhang JS, Cao SG, Rong ZP, Gao RQ, Han R, Shu SP |title=[Secondary prevention of esophageal cancer--intervention on precancerous lesions of the esophagus] |language=Chinese |journal=Zhonghua Zhong Liu Za Zhi |volume=10 |issue=3 |pages=161–6 |year=1988 |pmid=3219974 |doi= |url=}}</ref>


*In 1983, a study was carried out in Hishun village, China.
According to current guidelines, random endoscopic biopsies should be taken in all 4 quadrants and each 2 cm of columnar epithelium, and ideally performed with high-resolution endoscopes and NBI (narrow banding imaging).Dysplasia within BE lesions signals a marked increase in cancer risk: the annual risk is approximately 1% for patients with low-grade dysplasia and more than 5% for patients with high-grade dysplasia. However, 80% to 90% of cases of esophageal adenocarcinoma are diagnosed in patients without known BE. Endoscopic screening results in detection of BE in 6% to 12% of patients with prolonged GERD symptoms, most frequently white men older than 50 years of age
*Due to different dietary factors, the incidence of esophageal cancer amongst these people was particularly high.
 
*6758 subjects were examined by esophageal exfoliative cytology, 1729 had marked dysplasia and 2411 had mild dysplasia of esophageal epithelium.
Dysplasia within BE lesions signals a marked increase in cancer risk: the annual risk is approximately 1% for patients with low-grade dysplasia and more than 5% for patients with high-grade dysplasia. However, 80% to 90% of cases of esophageal adenocarcinoma are diagnosed in patients without known BE. Endoscopic screening results in detection of BE in 6% to 12% of patients with prolonged GERD symptoms, most frequently white men older than 50 years of age
*Those with marked dysplasia were randomly divided into 3 groups and given: antitumor B (Chinese herbs); retinamide (4-Ethoxycarbophenylretinamide) and placebo.  
 
*The subjects with mild dysplasia were randomly divided  into 2 groups for treatment with riboflavin and placebo.  
In one study, the authors concluded 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.
*They took their respective treatments for 3 years and were then reexamined using cytology.  
*The incidence of esophageal cancer in the antitumor B group was reduced by 53% as compared with that of the placebo group (8.3%).
*The incidence of esophageal cancer in retinamide and riboflavin groups were reduced by 33.7% and 19% as compared with those of the control groups.
*These results demonstrated that the secondary prevention of esophageal cancer is effective in the prevention of esophageal cancer.<ref name="pmid3219974">{{cite journal |vauthors=Lin PZ, Zhang JS, Cao SG, Rong ZP, Gao RQ, Han R, Shu SP |title=[Secondary prevention of esophageal cancer--intervention on precancerous lesions of the esophagus] |language=Chinese |journal=Zhonghua Zhong Liu Za Zhi |volume=10 |issue=3 |pages=161–6 |year=1988 |pmid=3219974 |doi= |url=}}</ref>


==References==
==References==

Revision as of 15:37, 11 December 2017

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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 with Barrett's esophagus-associated adenocarcinoma.

Screening

According to current guidelines, random endoscopic biopsies should be taken in all 4 quadrants and each 2 cm of columnar epithelium, and ideally performed with high-resolution endoscopes and NBI (narrow banding imaging).Dysplasia within BE lesions signals a marked increase in cancer risk: the annual risk is approximately 1% for patients with low-grade dysplasia and more than 5% for patients with high-grade dysplasia. However, 80% to 90% of cases of esophageal adenocarcinoma are diagnosed in patients without known BE. Endoscopic screening results in detection of BE in 6% to 12% of patients with prolonged GERD symptoms, most frequently white men older than 50 years of age

Dysplasia within BE lesions signals a marked increase in cancer risk: the annual risk is approximately 1% for patients with low-grade dysplasia and more than 5% for patients with high-grade dysplasia. However, 80% to 90% of cases of esophageal adenocarcinoma are diagnosed in patients without known BE. Endoscopic screening results in detection of BE in 6% to 12% of patients with prolonged GERD symptoms, most frequently white men older than 50 years of age

In one study, the authors concluded 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.

References


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