Recent findings

Three-tiered screening program proposed
Drs. Yusuf and Fitzgerald review recent technological advancements in screening for Barrett's esophagus and propose a three-tier approach using risk prediction algorithms and minimally invasive approaches to improving detection rate for Barrett's and EAC
Review of Barrett's and Esophageal Adenocarcinoma
The authors review the incidence of BE and EAC and associated risk factors, evidence for improved outcomes among patients with a prior diagnosis of BE compared to those without, discuss the challenges of developing sufficiently accurate prediction models in the context of high population prevalence of risk factors (e.g., obesity, reflux, smoking), and emphasize the need for larger biomarker studies.
Good news in treatment of esophageal cancer
Dr. Ilson's editorial in the New England Journal of Medicine puts new findings regarding the monoclonal antibody, nivolumab, in treatment of esophagal cancer in perspective. [Figure from original research article by Kelly, et al in same issue]
Review of world-wide GI cancer epidemiology
The authors extensively review the epidemiology (incidence, risk factors, prevention) of cancers of the colon, stomach and esophagus across China, the US and Europe
Dutch study on RFA/EMR effectiveness
In an observational study of 1154 patients with BE or early EAC, 94% achieved complete eradication after treatment with RFA/EMR. A dysplasia recurrence rate of 1% per year was observed over a median 43 months.
Modeling suggests a role for Cytosponge in post-RFA surveillance
This is one of the first examinations of the Cytosponge as a non-endoscopic method of surveillance in persons who have been treated for dysplasia in Barrett's. Results suggest that it may be more cost-effective than endoscopy.
Young onset esophageal adenocarcinomas have poorer prognosis
Young-onset esophageal adenocarcinoma, while uncommon, is rising in incidence. Concerningly, the proportion of advanced disease continues to increase. Young-onset esophageal adenocarcinoma also presents at more advanced stages, resulting in poorer esophageal adenocarcinoma–free survival.
EAC rates still rising in Czech Republic
Esophageal adenocarcinoma incidence is still rising about 5% per year in both women and men in the Czech republic, along with use of PPIs.
Predictive model for progression in Barrett's
Using a Bayesian approach, these authors combine results from multiple studies to risk stratify persons with Barrett's. They also identify potential changes in risk associated with preventive measures such as statin use and weight loss.
SEER study observes strong inverse association between EAC and use of PPI, statins and aspirin
A SEER-based observational study lends yet more evidence that aspirin, PPIs, statins and possibly metformin may reduce risk of EAC in persons with or without diagnosed Barrett's esophagus.
About
This website contains a curated and opinionated look at recent literature regarding the epidemiology and prevention of esophageal cancer, with an emphasis on esophageal adenocarcinoma. It is developed by Thomas L Vaughan MD, MPH, who can be reached with questions or suggestions through email or his research website.
©2021 Thomas L Vaughan
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