Game Changers in Gastroenterology: 2011

David A. Johnson, MD


November 23, 2011

In This Article

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.


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