Esophageal cancer - fast facts

The Fred Hutch Cancer Center (Seattle, WA) concisely presents helpful information on causes, symptoms and treatment options for both types of esophageal cancer, as well as additional resources for patients.

Oncogenic burden of obesity

This article provides a mechanistic framework relating obesity to increased risk of a number of gastrointestinal cancers, including esophageal adenocarcinoma. It also highlights the potential of weight loss interventions (e.g., lifestyle, pharmacologic, surgical) to reduce GI cancer risk. The authors describe a complex interplay of metabolic, inflammatory, microbial, and

Why Don't We Get Counseling?

This article addresses an interesting question: why are Barrett's esophagus patients not offered specialist counseling in much the same way as persons carrying genetic mutations (e.g., BRCA1/2) that confer increased cancer risk? Dr. Davies examines the contrasting approaches in UK NICE guidelines regarding psychosocial support for

Hot beverage intake and risk of esophageal cancer - a large prospective study in the UK

Drinking very hot beverages has long been suspected of causing esophageal squamous cell carcinoma through thermal injury; the International Agency for Research on Cancer (IARC) has classified it as "probably carcinogenic to humans." Much of the supporting evidence comes from studies in South America, particularly southern Brazil and

Screening and early diagnosis of upper GI neoplastic lesions: dedicated journal issue

The journal "Best Practice & Research Clinical Gastroenterology" has dedicated an entire issue toward research on the secondary prevention of esophageal and other upper GI cancers. These review articles include such topics as artificial intelligence, risk-based screening and cost effectiveness. Rather than summarizing these 12 informative articles, I

Improvements in post-surgical mortality for esophageal cancer

Although esophageal cancer remains one of the most deadly cancers, this Swedish population-based study from the Karolinska Institutet documents steady improvement in five-year survival rates over the past two decades. Among 2,291 patients undergoing esophageal cancer surgery, survival increased by about 3% per year despite patients being older and

Real-world experience with capsule sponge test

This large prospective observational study evaluated the potential usefulness of the Capsule Sponge (CS) test – a non-invasive method of collecting cellular samples from the esophageal lining – in a "real-world" setting at multiple NHS hospitals in the UK. Among the 2,170 patients who had a CS test, there

Circulating tumor DNA and recurrence of esophagogastric cancer

Persons with esophagogastric adenocarcinoma who undergo neoadjuvant therapy and curative-intent surgery are unfortunately still at risk for recurrence even with pathological complete (or near-complete) treatment response. If those likely to experience recurrence could be identified early they might benefit from additional treatment such as immunotherapy. This preliminary study investigates the

Cost-effectiveness analysis of Barrett's screening

From South Australia's Flinders University, Dr. Aoki and colleagues report on a cost-effectiveness analysis of various screening strategies for identifying Barrett's esophagus (BE) in the community, The study examined four primary screening tools: non-weighted clinical risk stratification, weighted risk stratification, the Cytosponge-TFF3 device, and traditional endoscopy

Liquid biopsy to diagnose esophageal adenocarcinoma

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

Neoplastic progression in young Barrett's patients

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,

Diagnosis and management of 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

Ethics of screening based on race/ethnicity

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

Tension between risk-based and patient-centered esophageal cancer screening

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

Eradication therapy for Barrett's

An evidence-based compendium of recommended treatments

AI in the assessment of Barrett's neoplasia

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 the Cytosponge for targeted screening of Barrett's

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

Asbestos exposure and esophageal cancer

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

Unrelated mortality after endoscopic eradication of Barrett's neoplasia

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

New cancer screening network announced

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

Update on Barrett's screening

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

Bariatric surgery vs medications in Barrett's

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

AI in screening and diagnosis of upper GI cancers and precursors

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

Gastric bypass surgery associated with reduced risk of esophageal adenocarcinoma

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=