This impressive multicenter study by Miyoshi et al. introduces a new diagnostic tool named EMERALD, which is a six-circulating miRNA signature designed to effectively differentiate patients with esophageal adenocarcinoma (EAC) and its precursor, Barrett's esophagus (BE), from non-disease controls. The research involved analyzing 792 patient samples across four
Esophageal adenocarcinoma is quite rare among persons younger than 40 years, but the consequences of the disease, including years of life lost, can be devastating. Due to its rarity there has been little research on how risk factors in young persons (e.g., Barrett's esophagus (BE), obesity, GERD,
While most adults occasionally experience symptoms of gastroesophageal reflux, such as heartburn and regurgitation, approximately 20% (30 million people in the U.S.) experience these symptoms more frequently, ranging from once a week to multiple times a day. (1) Complications associated with GERD can include esophageal strictures, ulcers, and even
An educational resource dedicated to the prevention and control of esophageal cancer. Each year over 600,000 people in the world are diagnosed with esophageal cancer. Unfortunately most do not survive more than a year, making it the sixth most common cause of cancer-related death. Much is known about the
The esophagus (blue in figure) is a muscular tube that carries food from the back of the mouth (pharynx – green) to the stomach (red) (figure 1). Cancers that occur in this organ are often difficult to treat, in part because “alarm symptoms” such as difficulty swallowing (dysphagia) or bleeding often
Esophageal Adenocarcinoma Epidemiologic and clinical research has revealed many risk factors which, taken together, can help estimate a person’s probability of developing esophageal adenocarcinoma (EAC). These include: * demographic factors, * host and lifestyle factors, * medications, * family history, and * genetic markers. In the general population, symptomatic gastroesophageal reflux (sGERD), obesity, cigarette
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This article explores some of the ethical implications of using race and ethnicity for cancer screening, using esophageal adenocarcinoma and gastric cancer as examples. It highlights the disparities in cancer incidence and mortality among different racial and ethnic groups and examines the potential benefits and drawbacks of screening based (in
This interesting and thoughtful paper by Dr. Elspeth Davies at the University of Cambridge investigates the use of the capsule sponge test for screening Barrett's esophagus (BE) in a mobile clinic in England, highlighting the challenges in balancing patient-centered and risk-centered medical management. Through ethnographic fieldwork, the study
An evidence-based compendium of recommended treatments
Accurate and timely identification of Barrett’s-related (BE) dysplasia is critical to providing the timely surveillance and treatment needed to prevent progression to esophageal adenocarcinoma. Unfortunately, significant observer variability in the assessment of BE-related dysplasia by pathologists continues to be a challenge. This report discusses the development and application of
Using data from the previously published BEST3 clinical trial (1), the authors estimated the potential for improving the detection of Barrett's esophagus (BE) and early esophageal adenocarcinoma (EAC) among individuals aged 50 and above with gastroesophageal reflux disease (GERD). They calculated that the current referral strategies identify only
Exposure to asbestos, whether through occupational or environmental routes, can cause several cancers, including mesothelioma and lung. It’s role in increasing risk of esophageal cancer (EC) has long been suspected, but not yet confirmed. In this thorough meta-analysis, 48 independent cohort and case-control studies were analyzed using random-effects models
This study provides valuable context for patients and their physicians concerned about future health implications of their diagnosis and treatment for Barrett's neoplasia (dysplasia or early cancer.) It investigates the risk of mortality unrelated to esophageal adenocarcinoma (EAC) in patients who have undergone endoscopic eradication therapy (EET) for
In exciting news on the prevention/screening front, The Fred Hutchinson Cancer Center is leading a new clinical trials consortium called the Cancer Screening Research Network (CSRN), established by the National Cancer Institute, with the aim of advancing President Biden’s Cancer Moonshot initiative. The CSRN will focus on improving
While not breaking new ground, this manuscript from Mayo Clinic nicely reviews state of the art approaches to screening (and surveillance) for Barrett's esophagus and esophageal adenocarcinoma. These newer techniques including: three different swallowable cell sampling devices combined with biomarkers (now approved in society guidelines), capsule-based imaging, and
Does bariatric surgery influence subsequent risk of esophageal adenocarcinoma? Depending on whom and when you ask, what population or subpopulation you study, and which surgical procedures are considered, studies variously suggest no effect, increased risk and reduced risk. Moreover, some of the apparently discrepant results originate from the same author
There is currently a great deal of interest in the role of Artifical Intelligence (AI) in medicine, particularly in specialties involving visualization. Upper gastrointestinal endoscopy, employed in the screening, surveillance and diagnosis of esophageal and gastric cancer and their precursors, is one such area that is especially promising in increasing
This large multinational observational study investigated whether bariatric surgery was associated with reduced risk of esophageal and cardia adenocarcinoma (ECA) in individuals diagnosed with “morbid” obesity. The study involved a cohort of almost 750,000 persons from Sweden, Finland, and Denmark, grouped based on whether they underwent bariatric surgery (n=
