Esophageal cancer screening
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Esophageal cancer Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Esophageal cancer screening On the Web |
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American Roentgen Ray Society Images of Esophageal cancer screening |
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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 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.