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