COMMENTARY

Game Changers in Gastroenterology: 2011

David A. Johnson, MD

November 23, 2011

Esophageal Adenocarcinoma Incidence in Individuals With Gastroesophageal Reflux: Synthesis and Estimates From Population Studies

Rubenstein JH, Scheiman JM, Sadeghi S, Whiteman D, Inadomi JM.
Am J Gastroenterol. 2011;106:254-260.

These researchers questioned whether the standard practice of screening for BE in patients with chronic GERD has value relative to other standardly performed preventative/screening programs. They created a Markov computer model using readily available national surveillance data to estimate the age- and gender-specific incidences of EAC among non-Hispanic white individuals with GERD in the United States. To place the results in context, they cited incidences of breast cancer and CRC, for which screening recommendations are well-established.

For a woman aged 60 years, with weekly GERD symptoms, incidence of EAC was 3.9/100,000 person-years (similar to the incidence of breast cancer in men) compared with 34.6/100,000 for a man with weekly GERD symptoms. The incidence of EAC in men < 50 years of age with weekly GERD symptoms was relatively low compared with those > 60 years of age. For example, the incidence of EAC was 1.0/100,000 person-years at 35 years (6.7 times lower than the incidence of CRC) vs 60.8/100,000 at 70 years (3 times lower than the incidence of CRC).

Why Is This a Game Changer?

These data suggest that women with GERD have the same risk for EAC as men have for breast cancer -- a point that may be a useful perspective for clinicians to apply to their practice and help them understand the relative value of their current screening practice.

1 2 3 4 5 6 7 8 9 10

Next Section

Cite this: David A. Johnson. Game Changers in Gastroenterology: 2011 - Medscape - Nov 23, 2011.

Comments

Commenting is limited to medical professionals. To comment please Log-in.

Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.