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