Time to Challenge Current Strategies for Detection of Barrett’s Esophagus and Esophageal Adenocarcinoma
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Adenocarcinoma of the esophagus (EAC) is a disease with a high mortality rate since initial detection usually occurs at an advanced stage in the majority of patients . For example, data demonstrate that 50% of patients are diagnosed at stage II or higher with 20% diagnosed with stage IV disease . As a result, even in this decade, the overall 5-year survival for EAC remains under 25% , despite increased efforts directed at increasing physician and patient awareness, multiple published society guidelines, and advances in endoscopic procedural quality and imaging. That the survival of EAC has not changed appreciably over the past two decades implies that a fundamental issue is not being addressed regarding the pathophysiology and classification of EAC. In this article, we will attempt to identify some of these issues.
De Novo Versus Surveillance-Detected EAC
It has long been recognized that that de novo EAC far outnumbers surveillance-detected EAC. A study...
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Conflict of interest
DAK was involved in Research funding Shire, Honorarium Celgene, and RCF was listed as an inventor on patents pertaining to Cytosponge and associated assays which have been licensed by the Medical Research Council to Medtronic.