Symptoms of Early Cancer Especially Barrett’s Carcinoma

Abstract

The incidence of the adenocarcinoma of the esophagus (AC) has been rising exponentially in the Western World within the last 30 years. The reasons for this increase are not yet understood. Massive and long lasting gastroesophageal reflux causes the Barrett’s esophagus which is considered to be a precancerosis. Therefore early diagnosis and appropriate treatment of gastroesophageal reflux is essential for the prevention of this tumor. This makes heartburn the leading clinical symptom in the patient’s history. In patients with heartburn it is possible to early endoscopically diagnose a Barrett’s esophagus or adenocarcinoma of the esophagus. However only few patients with this increased risk receive an index-endoscopy. In clinical studies a high rate of early carcinomas could be found and could be treated with mucosectomie or ablation. The majority of patients with AC present with symptoms suggestive of progressed disease such as dysphagia or weight loss. The prognosis in patients in late disease stages are with a 5-year survival of only 30% far worse than in patients with early carcinoma (85%). However the early symptoms such as heartburn or regurgitation are unspecific and make an effective diagnostical strategy difficult. To optimize screening it would be beneficial to identify patients with high risk for the development of adenocarcinoma of the esophagus.