Game Changers in Gastroenterology: 2011

David A. Johnson, MD


November 23, 2011

In This Article

Patients With Nondysplastic Barrett's Esophagus Have Low Risks for Developing Dysplasia or Esophageal Adenocarcinoma

Wani S, Falk G, Hall M, et al.
Clin Gastroenterol Hepatol. 2011;9:220-227.

In this study from 5 tertiary referral centers, Wani and colleagues evaluated incidence and progression of esophageal adenocarcinoma (EAC) and HGD in a prospective cohort of 1204 patients (94% white; 88% men; mean age, 59.3 years). All patients had nondysplastic BE and received routine biopsies that were interpreted by an expert pathologist at each of the participating institutions. During a mean follow-up of 5.52 years, annual incidence rates of EAC and HGD were 0.27% and 0.48% respectively, and mean time to development was 5.3 years and 5.6 years, respectively. Cancer-free survival at 5, 8, and 10 years was 98.6%, 97.5% and 97.1%.

Why Is This a Game Changer?

These incidence rates of EAC and HGD are approximately half those from other recent studies. This raises the question of cost-effectiveness of current surveillance intervals. Of interest, a prior analysis[2] estimated that the annual incidence of EAC would need to be >1.9% per year for surveillance of non-dysplastic BE at 5-year intervals to be cost-effective.


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.