Barrett's Oesophagus: Today's Mistake and Tomorrow's Wisdom in Screening and Prevention.

IF 1.8 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Visceral Medicine Pub Date : 2022-06-01 DOI:10.1159/000522015

W Keith Tan, Massimiliano di Pietro

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引用次数: 2

Abstract

Background: Oesophageal adenocarcinoma (OAC) is a lethal cancer with an overall 5-year survival of <20%. Given the presence of a pre-invasive disease stage, also known as Barrett's oesophagus (BO), and the availability of minimally invasive treatments for BO-related neoplasia, it is thought that early detection is the best strategy to improve patient outcomes. Clinical guidelines recommend endoscopic screening in patients with symptoms of acid reflux and additional risk factors. This strategy is flawed by the cost and invasiveness of endoscopy as well as by the fact that a significant proportion of OAC patients deny a history of reflux symptoms.

Summary: New research on the use of epidemiologic and clinical data has allowed the creation of risk-prediction algorithms to identify the population at risk. In addition, newer less-invasive devices such as transnasal endoscopy, Cytosponge, volumetric laser endomicroscopy, and volatile organic compounds are emerging as promising options to allow screening in the primary care setting. Finally, there is an opportunity to intervene at the pre-invasive stage with pharmacological strategies to reduce the risk burden.

Key messages: In this review, we provide a critical appraisal of the different screening approaches and chemopreventive strategies and a guide to readers on how to implement research evidence in clinical practice.

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巴雷特食道:今天的错误和明天的筛查和预防的智慧。

背景:食管癌(OAC)是一种致死性癌症，其5年总生存率为。摘要:利用流行病学和临床数据的新研究已经允许创建风险预测算法来识别处于危险中的人群。此外，较新的低侵入性设备，如经鼻内镜、细胞海绵、体积激光内镜和挥发性有机化合物等，正在成为初级保健环境中筛查的有希望的选择。最后，有机会在侵入前阶段通过药理学策略进行干预，以减少风险负担。关键信息:在这篇综述中，我们对不同的筛查方法和化学预防策略进行了批判性评估，并为读者提供了如何在临床实践中实施研究证据的指南。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Visceral Medicine Medicine-Surgery

CiteScore

4.50

自引率

0.00%

发文量

期刊介绍： This interdisciplinary journal is unique in its field as it covers the principles of both gastrointestinal medicine and surgery required for treating abdominal diseases. In each issue invited reviews provide a comprehensive overview of one selected topic. Thus, a sound background of the state of the art in clinical practice and research is provided. A panel of specialists in gastroenterology, surgery, radiology, and pathology discusses different approaches to diagnosis and treatment of the topic covered in the respective issue. Original articles, case reports, and commentaries make for further interesting reading.