Editorial
Barrett’s Esophagus and Adenocarcinoma of Esophagus
Tai-Long Chien, MD 1, Yu Sophie Wang, BSc 2 and Jeng-Shing Wang, MD, MSc, FCCP 1,3*
1Division of Internal Medicine, Antai Medical Care Cooperation Antai Tian-Sheng Memorial Hospital, Pingtung,
2Public Health Program, Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada
3Department of Medicine, Taipei Medical University, Taipei, Taiwan
Corresponding author
Dr. Jeng-Shing Wang, No. 166 Min-Shiang Street, Kaohsiung 800, Taiwan, Tel: 886-8-8329966; Fax: 886-8-8329977; E-mail: wangjs6@hotmail.com
Received Date: 12-June-2014
Accepted Date: 25 Jun 2014
Published Date: 27 Jun 2014
Citation
Chien LY, Wang YS, Wang JS (2014) Barrett’s Esophagus and Adenocarcinoma of Esophagus. Enliven: Challenges Cancer Detect Ther 1(1): e003.
Copyright
@ 2014 Dr. Jeng-Shing Wang. This is an Open Access article published and distributed under the terms of the Creative Commons Attribution License that permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.
Abstract
Barrett’s esophagus is a premalignant lesion detected in the majority of patients with esophageal and gastroesophageal adenocarcinoma, which are associated with a low rate of survival (5-year survival rate, 15 to 20%). The annual incidence of esophageal cancer for the general population of patients with Barrett’s esophagus is approximately 0.5% per year. In the past, the incidence of gastroesophageal reflux disease (gastroesophageal reflux disease, GERD) in Western countries is much higher than Asian countries, which is about 2-4 times. But in recent decades statistics have found that the incidence of GERD in Asian countries has significantly increased. In Singapore, the prevalence of GERD increased from 4.3% to 10% between 1992 to 2001, in South Korea from 1.8% to become 9.1% ( 10 years period ), in Taiwan from 5% to 12.6% between 1995 to 2002. And the prevalence was increased up to 25% in taiwan (between 2008 and 2009). Chronic GERD is the major risk factor of Barrett’s esophagus. Endoscopic surveillance has become the standard of practice for patients with Barrett’s esophagus based on the unproven assumption that the practice will reduce deaths from esophageal adenocarcinoma and thereby prolong survival. The patients with Barrett’s esophagus who are most likely to benefit from endoscopic eradication therapy are those with esophageal adenocarcinoma limited to the mucosa and those with high-grade dysplasia.
Barrett’s esophagus is a premalignant lesion detected in the majority of patients with esophageal and gastroesophageal adenocarcinoma, which are associated with a low rate of survival (5-year survival rate, 15 to 20%) [1]. The annual incidence of esophageal cancer for the general population of patients with Barrett’s esophagus is approximately 0.5% per year [2]. In the past, the incidence of gastroesophageal reflux disease (gastroesophageal reflux disease, GERD) in Western countries is much higher than Asian countries, which is about 2-4 times. But in recent decades statistics have found that the incidence of GERD in Asian countries has significantly increased. In Singapore, the prevalence of GERD increased from 4.3% to 10% between 1992 to 2001, in South Korea from 1.8% to become 9.1% ( 10 years period ), in Taiwan from 5% to 12.6% between 1995 to 2002. And the prevalence was increased up to 25% in taiwan (between 2008 and 2009). Chronic GERD is the major risk factor of Barrett’s esophagus [3]. Endoscopic surveillance has become the standard of practice for patients with Barrett’s esophagus based on the unproven assumption that the practice will reduce deaths from esophageal adenocarcinoma and thereby prolong survival. The patients with Barrett’s esophagus who are most likely to benefit from endoscopic eradication therapy are those with esophageal adenocarcinoma limited to the mucosa and those with high-grade dysplasia [1].
Societal guidelines generally have recommended endoscopic surveillance for patients with Barrett’s esophagus at intervals that vary with grade of dysplasia found in the metaplastic epithelium. Intervals of 3 to 5 years have been suggested for patients who have no dysplasia, 6 to 12 months for those found to have low-grade dysplasia, and every 3 months for patients with high-grade dysplasia who receive no ablation therapy. Endoscopic mucosal resection has been used for both diagnostic and therapeutic purposes.
Conflict-of-interest
None
References
1. Sharma P (2009) Clinical practice. Barrett's esophagus. N Engl J Med 361: 2548-2556.