Diseases of the Esophagus最新文献

{"title":"The prevalence, nature and severity of oropharyngeal dysphagia in the acute post-operative phase following curative resection for esophageal cancer.","authors":"Michelle Hayes, Anna Gillman, Jessie A Elliott, Claire L Donohoe, John V Reynolds, Julie Regan","doi":"10.1093/dote/doaf054","DOIUrl":"10.1093/dote/doaf054","url":null,"abstract":"<p><strong>Background: </strong>Oropharyngeal dysphagia and aspiration in the early post-esophagectomy period is rarely studied. This study investigated its prevalence, nature and severity, differences across surgical subgroups, and predictors of risk.</p><p><strong>Methods: </strong>A prospective cohort study was conducted (January 2022-January 2024) at the National Esophageal Cancer Centre. Data was collected on post-operative day (POD) 4 or 5. Swallowing evaluations included videofluoroscopy [Dynamic Imaging Grade of Swallowing Toxicity v2(DIGESTv2), Modified Barium Swallow Impairment Profile (MBSImP), Penetration-Aspiration Scale (PAS)]. Functional Oral Intake Scale (FOIS) was used to identify oral intake status.</p><p><strong>Results: </strong>N = 30 (25 males) were recruited, mean age (range) of 65 (46-80y), n = 13 2-stage, n = 8 3-stage, and n = 9 transhiatal resections. At POD 4/5, 60% (18/30) showed signs of aspiration, with no differences across surgical groups (P = 0.114). Dysphagia per the DIGESTv2 was present in 83% (25/30) of patients, with severe dysphagia in 23% (7/30). MBSImP assessment revealed reduced tongue base retraction (82%), pharyngeal residue (100%) and impaired neo-esophageal clearance (100%). Predictors of aspiration were: pre-operative abnormal FOIS (score < 7) (OR = 7.00, 95%CI 1.2-38.4; P = 0.024), and > 65 years (OR = 7.80, 95%CI 1.47-41.6; P = 0.016). Predictors for oropharyngeal dysphagia were: abnormal pre-operative FOIS (score < 7) (OR = 7.42, 95%CI 1.22-45.45; P = 0.029); age > 65 years (OR = 11.00, 95%CI 1.99-58.8; P = 0.006) and neoadjuvant treatment (OR = 7.20, 95%CI 1.08-47.96, P = 0.041).</p><p><strong>Conclusion: </strong>Oropharyngeal dysphagia and aspiration are prevalent in the early period after esophageal cancer surgery. These data should inform an increased input from speech and language specialists in the assessment and management of post-operative patients, and overall caution in the implementation and progression of early per orum intake.</p>","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":"38 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12253955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dupilumab adverse reactions in eosinophilic esophagitis treatment: a Food and Drug Administration Adverse Event Reporting System database analysis.","authors":"Kasey Bowyer, Austin R Swisher, Nancy Jiang, Jonathan Liang","doi":"10.1093/dote/doaf055","DOIUrl":"https://doi.org/10.1093/dote/doaf055","url":null,"abstract":"<p><p>Dupilumab, the first biologic approved for eosinophilic esophagitis treatment (EoE-tx) in 2022, demonstrated favorable safety in phase-III clinical trials. However, real-world dupilumab-associated adverse reactions (DARs) for EoE-tx are unknown. This study aims to evaluate DAR for EoE-tx using the FDA Adverse Event Reporting System. FDA Adverse Event Reporting System was queried for DAR between 2022Q1 and 2023Q4. Individual DARs (iDARs) were categorized and compared between treatment groups: EoE, asthma, atopic dermatitis, and chronic rhinosinusitis with nasal polyps. Logistic regression was used to predict serious DAR and outcomes, and zero-truncated negative binomial regression was used to predict the number of iDAR. There were 51,000 DAR observations; 1459 for EoE-tx with 103 (7.1%) serious reactions and 44 (3.0%) serious outcomes including 3 deaths. For EoE-tx, the mean iDAR was 3.68 [3.51, 3.85], and the iDAR incidence rate ratio among men receiving EoE-tx was 0.73 [0.65, 0.83]. EoE-tx average iDAR primarily included general (0.75 [0.70, 0.80]), injection-site (0.69 [0.63, 0.74]), dermatologic (0.51 [0.46, 0.55]), and gastrointestinal (0.24 [0.21, 0.27]) reactions. Adults ≥50 years had 1.97 [1.28, 2.99] higher odds for serious DAR compared to younger adults in EoE-tx. Overall, dupilumab demonstrated a favorable safety profile across all indications, with low rates of serious adverse events. For EoE-tx specifically, higher total iDAR rates were observed, driven largely by increased injection-site and gastrointestinal reactions compared to other indications. Additionally, women exhibited higher iDAR rates than men across all indications.</p>","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":"38 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The potential utility of CHATGPT4.0 as an AI assistant in the education and management of patients with Barrett's esophagus.","authors":"Frances Dang, Josh Kwon, Andy Lin, Shoujit Banerjee, Trevor McCracken, Amirali Tavangar, Shravani R Reddy, Alyssa Y Choi, Jennifer Phan, Jeffrey D Mosko, Samir C Grover, Tyler M Berzin, Jason Samarasena","doi":"10.1093/dote/doaf050","DOIUrl":"10.1093/dote/doaf050","url":null,"abstract":"<p><p>Chat Generative Pre-trained Transformer (ChatGPT) has emerged as a new technology for physicians and patients to obtain medical information. Our aim was to assess the ability of ChatGPT 4.0 to deliver high-quality information in response to commonly asked questions and management recommendations for Barrett's esophagus (BE). Twenty-nine questions (14 clinical vignettes and 15 frequently asked questions (FAQ)) on BE were entered into ChatGPT 4.0. Using a 5-point Likert scale, three gastroenterologists with expertise in BE rated the 29 ChatGPT responses for accuracy, completeness, empathy, use of excessive medical jargon, and appropriateness to send to patients. Three separate gastroenterologists generated responses to the same 15 FAQs on BE. A group of blinded patients with BE evaluated both ChatGPT and gastroenterologist responses on quality, clarity, empathy and which of the two responses was preferred. Gastroenterologists rated ChatGPT responses as mostly accurate overall (4.01 out of 5) with 79.3% of responses completely accurate or mostly accurate with minor errors. When compared to gastroenterologist responses, the patient panel rated ChatGPT responses to be of significantly higher quality (4.42 vs. 3.07 out of 5) and empathy (4.33 vs. 2.55 out of 5) (p < 0.0001). In conclusion, ChatGPT 4.0 provides generally accurate and comprehensive information about BE. Patients expressed a clear preference for ChatGPT responses over those of gastroenterologists, finding responses from ChatGPT to be of higher quality and empathy. This study highlights the potential use of ChatGPT 4.0 as an adjunctive tool for physicians to provide real-time, high-quality information about BE to their patients.</p>","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":"38 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lessons learned: a safe and effective approach to esophageal dilation in eosinophilic esophagitis.","authors":"Andrew Canakis, Evan S Dellon","doi":"10.1093/dote/doaf045","DOIUrl":"https://doi.org/10.1093/dote/doaf045","url":null,"abstract":"<p><p>Eosinophilic esophagitis (EoE) has emerged as a widely recognized disease process, and medical and diet therapies can provide effective anti-inflammatory treatment. However, the progressive fibrostenotic nature of EoE leads to esophageal remodeling and strictures, as well as clinical symptoms of dysphagia and food impaction. In this context, esophageal dilation during endoscopy provides effective symptomatic relief and is an important adjunct therapy. Recognition of esophageal strictures and safe dilation practices is paramount for providers who care for patients with EoE. This review will describe our approach for safe and effective endoscopy management of esophageal strictures in EoE.</p>","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":"38 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Positional effects on gastric pressures and esophagogastric pressure gradients in patients with gastroesophageal reflux.","authors":"Yassmin K Hegazy, Sydney F Pomenti, Daniela Jodorkovsky, Daniel E Freedberg, David A Katzka","doi":"10.1093/dote/doaf053","DOIUrl":"https://doi.org/10.1093/dote/doaf053","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Most mechanistic research on gastroesophageal reflux disease (GERD) focuses on LES pressure (LESP) and not the gastric-LESP gradient required to facilitate regurgitation. Our study focuses on gastric pressures (GP) during high-resolution manometry (HRM) and the magnitude and pressure gradient direction across the LES in patients with normal, upright, and supine GERD at baseline and with swallows.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Our study is a retrospective study evaluating patients who underwent HRM and 24 h impedance and categorized as patients with normal, upright, and supine esophageal acid exposure. Data was collected from the electronic medical record at our institution. GP was measured 2 centimeters (cm) below the LES at baseline and before and during swallows. Results were measured as means, medians, and standard deviations for continuous variables between the three groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;42 patients were evaluated, including 22 normal (14F), 10 upright (8F), and 10 (8F) supine refluxers. Normal patients had a total acid exposure time of 1.4% (IQR 0.8-2.8%), upright had 6.4% (4.6-7.8%), and supine had 11.4% (7.8-21%). At baseline, the LESP was 35.59 mmHg, 31.97 mmHg, and 25.38 mmHg while the mean GP was 20.90 mmHg, 19.49 mmHg, and 21.80 mmHg, for normal, upright, and supine patients, respectively. No differences were seen in the mean GP during supine and upright swallow positions within any of the phenotypic groups, or when comparing differences in GP between upright vs. supine swallows across the three groups (Kruskal-Wallis P = 0.25). During upright swallows, the maximum GP was 15.8 mmHg (12.5-19.4), 17.2 (13.7-21.1), and 16.4 (14.1-22.7); LESP was 34.6 mmHg (IQR 27.4-47.2), 34.1 (25.3-36), and 21.7 (16.4-28.1); and integrative relaxation pressure (IRP) was 14.0 (10.6-17.3), 11.8 (10.6-15.5), and 8.8 (5.6-14.4) for the normal, upright and supine groups respectively. For normal patients, LESP consistently exceeded mean GP; during supine swallows, one patient in the normal group had median GP &gt; LESP. For the upright group, 15/48 and 28/48 swallows had GP &gt; IRP in the upright and supine positions, respectively. For the supine group, 24/48 and 32/48 swallows had GP &gt; IRP upright and supine positions, respectively. During upright swallows, the median within-individual pressure gradient (IRP minus GP) was +6.2 mmHg (+3.9 to +11.3) for normal patients without reflux, +5.7 (+1.1 to +7.3) for patients with upright reflux, and + 1.4 (-0.3 to +5.0) for patients with supine reflux; during supine swallows, the same within-individual pressure gradient was +6.7 (+2.7 to +9.1), +4.0 (+2.4 to +6.3), and - 0.8 (-4.6 to +4.8) for the groups respectively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study demonstrates that the magnitude of LES-GP gradient decrease is related to the positional phenotype of gastroesophageal reflux with the lowest gradient seen in supine refluxers. It is This suggests that measurin","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":"38 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative effect between Zenker's peroral endoscopic myotomy and alternatives in the treatment of Zenker's diverticulum: a systematic review and meta-analysis.","authors":"Apostolis Papaefthymiou, Andrea Telese, Benjamin Norton, Daryl Ramai, Georgios Tziatzios, Paraskevas Gkolfakis, Martin Birchall, Borzoueh Mohammadi, Muntzer Mughal, Rehan Haidry","doi":"10.1093/dote/doaf047","DOIUrl":"10.1093/dote/doaf047","url":null,"abstract":"<p><strong>Background: </strong>Zenker's diverticulum (ZD) is a rare outpouching of the pharyngeal mucosa in the upper oesophagus, predominantly affecting elderly patients. Historically, the management for ZD has been surgery, but less invasive endoscopic techniques have also emerged. One technique that has gained traction is Zenker's peroral endoscopic myotomy (Z-POEM), but there remains no clear consensus on the optimal modality. This study aimed to compare the effectiveness and safety of Z-POEM with alternative treatments, including flexible and rigid diverticulotomy.</p><p><strong>Methods: </strong>A literature search across MEDLINE, Cochrane, and Scopus databases identified comparative studies evaluating ZD treatments, through October 2024. Outcomes included technical and clinical success, reintervention rates, and adverse events. Data were synthesized using a random-effects model, and heterogeneity was assessed with the I2 index. Subgroup analyses were performed for specific comparisons.</p><p><strong>Results: </strong>Seven studies involving 747 patients met inclusion criteria. Technical success was high for both Z-POEM (97.4%) and alternatives (95.8%). Clinical success significantly favored Z-POEM (odds ratio [OR]: 2.14 [95% confidence interval: 1.42-3.21]). Reintervention rates were not significantly different and adverse event rates were comparable (9.4% for Z-POEM vs. 12.4% for alternatives), with fewer perforations in Z-POEM. Subgroup analysis revealed that Z-POEM maintained comparable technical success, reintervention, and adverse events rates and achieved significantly higher clinical success than flexible (OR: 2.20) and rigid diverticulotomy (OR: 1.98).</p><p><strong>Conclusion: </strong>Z-POEM demonstrated superior clinical success compared to alternative techniques. However, the low quality of evidence underscores the need for well-designed studies to validate these findings, and guide treatment decisions for ZD.</p>","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":"38 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of immunoenteric nutrition versus general enteral nutrition on prognosis in patients with squamous cell carcinoma undergoing radical esophagectomy post neoadjuvant chemotherapy.","authors":"Guanghui Zhu, Xiaobin Song, Qin Wang, Zheng Zhang, Maotian Xu, Fei Xu, Jing Luo, Chi Zhang, Yi Shen","doi":"10.1093/dote/doaf027","DOIUrl":"https://doi.org/10.1093/dote/doaf027","url":null,"abstract":"<p><p>Malnutrition is a common complication among patients with esophageal cancer, significantly increasing the risk of postoperative complications and mortality. Multiple studies have shown that immunoenteric nutrition (IEN) can reduce postoperative infectious complications in patients with esophageal cancer. However, its prognostic impact on patients undergoing radical surgery following neoadjuvant therapy remains unclear. This study aimed to compare the prognostic effects of IEN versus standard enteral nutrition (EN) in patients with esophageal squamous cell carcinoma (ESCC) following radical esophageal cancer surgery after neoadjuvant therapy. This retrospective study included 197 patients with ESCC who underwent radical esophagectomy following neoadjuvant therapy between 2016 and 2022. Of these, 133 patients received postoperative standard EN, while 64 patients received IEN. The primary endpoints were overall survival (OS) and progression-free survival (PFS). The secondary endpoints included the incidence of postoperative complications and changes in relevant blood markers before and after surgery. No significant differences were observed in postoperative hospitalization duration or complications between the two groups. Postoperative C-reactive protein and immunoglobulin M levels were significantly lower in the IEN group compared to the EN group (P = 0.018 and 0.042). Kaplan-Meier survival curves were plotted for 1, 2, 3, and 5 years to compare the effects of IEN and EN on OS and PFS. The log-rank test revealed the following survival rates: 90.6% versus 77.2% (1-year PFS, P = 0.023); 95.3% versus 82.7% (1-year OS, P = 0.015); 71.9% versus 56.7% (2-year PFS, P = 0.035); 76.6% versus 62.4% (2-year OS, P = 0.03); 54.6% versus 41.7% (3-year PFS, P = 0.064); 61.4% versus 49.3% (3-year OS, P = 0.08); 39.4% versus 30.7% (5-year PFS, P = 0.093); and 41.5% versus 32.6% (5-year OS, P = 0.104). Univariate and multivariate analyses identified several independent predictors of 2-year PFS and OS. For 2-year PFS, the independent predictors included body mass index (P = 0.005), ypTNM stage (Pathologic TNM-staging after neoadjuvant therapy) (P = 0.045), ypT stage (Pathologic T-staging after neoadjuvant therapy) (P = 0.030), ypN stage (Pathologic N-staging after neoadjuvant therapy) (P = 0.007), tumor differentiation (P = 0.031), and type of EN (P = 0.004). For 2-year OS, the independent predictors were age (P = 0.015), body mass index (P = 0.004), ypTNM stage (P = 0.013), ypT stage (P = 0.010), ypN stage (P = 0.009), tumor differentiation (P = 0.026), and type of EN (P = 0.001). In patients with ESCC undergoing esophagectomy after neoadjuvant therapy, postoperative IEN accelerates the resolution of the inflammatory state and improves short-term survival, though its long-term benefits remain uncertain. Furthermore, IEN does not significantly affect the postoperative hospitalization duration or the incidence of complications.</p>","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":"38 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact on Barrett's dysplasia yield following the introduction of capsule sponge testing versus traditional endoscopic surveillance.","authors":"Siobhan Chien, Paul Glen","doi":"10.1093/dote/doaf033","DOIUrl":"https://doi.org/10.1093/dote/doaf033","url":null,"abstract":"<p><strong>Background: </strong>Capsule sponge testing for Barrett's surveillance is emerging as an innovative technology to aid endoscopic surveillance programs but has yet to be compared to traditional endoscopy in clinical practice. This study aims to establish the impact of the introduction of capsule sponge testing on dysplasia detection rates.</p><p><strong>Methods: </strong>Over a 5-year period, data were collected for all patients undergoing endoscopy and capsule sponge testing for Barrett's surveillance in a single health board. The 2-year periods pre- and post-implementation of capsule sponge testing were compared to assess dysplasia yield. Patients undergoing surveillance over the 2-year period 1 January 2021 to 31 December 2022 were dichotomized into two groups: capsule sponge test (±subsequent endoscopy) versus endoscopic surveillance only, to compare endoscopic biopsy results.</p><p><strong>Results: </strong>Barrett's surveillance was performed in 1568 patients between 1 January 2018 and 31 December 2019 (pre-intervention group) versus 1791 patients between 1 January 2021 and 31 December 2022 (implementation group). In the implementation group, 871 patients underwent traditional endoscopy versus 920 patients undergoing capsule sponge testing (with 157 patients [17.1%] proceeding to endoscopy after capsule sponge test). There were no significant differences in the rates of high grade dysplasia (HGD), intramucosal cancer (IMC), or invasive cancer diagnosed between the groups. However, yield of indefinite for dysplasia and low grade dysplasia (LGD) cases was higher in the endoscopic surveillance cohort.</p><p><strong>Conclusions: </strong>Capsule sponge testing is non-inferior to traditional endoscopic surveillance for detecting HGD, IMC, and cancer. Further follow-up is required to ensure early dysplasia is diagnosed appropriately in those undergoing capsule sponge testing for Barrett's surveillance.</p>","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":"38 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does the SANO trial really move us toward organ preservation for esophageal cancer?","authors":"Sheraz R Markar, Mark Van Berge Henegouwen, Christiane Bruns, Lorenzo Ferri, Richard van Hillegersberg, Wayne Hofstetter, Magnus Nilsson","doi":"10.1093/dote/doaf049","DOIUrl":"https://doi.org/10.1093/dote/doaf049","url":null,"abstract":"","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":"38 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computing lifetime incidence of esophageal adenocarcinoma and age-specific prevalence of Barrett's esophagus.","authors":"Ravi Vissapragada, Norma B Bulamu, David C Whiteman, Tim Bright, Jonathan Karnon, David I Watson","doi":"10.1093/dote/doaf038","DOIUrl":"10.1093/dote/doaf038","url":null,"abstract":"<p><p>Barrett's esophagus is the precursor to esophageal adenocarcinoma. Esophageal adenocarcinoma detected from endoscopic surveillance programs accounts for <10% of all cases, suggesting majority of patients with Barrett's esophagus are likely unaccounted for. Previous observational studies have estimated the observed prevalence of Barrett's esophagus to be approximately 1%, but others suggest may be an underestimate. The aim of this study was twofold: (i) calculate lifetime risk of esophageal adenocarcinoma and (ii) estimate overall and age-specific prevalence of Barrett's esophagus. A tree cohort model was created for progression to esophageal adenocarcinoma from birth to death (100 years) for USA and Australian population. Lifetime risk of esophageal cancer and adenocarcinoma were necessary for calculating Barrett's esophagus prevalence. The model incorporated age- and sex-specific incidence data from national cancer registries: the Australian Institute of Health and Welfare and the Surveillance, Epidemiology, and End Results database for the USA. The model was calibrated using an optimization algorithm, which matched progression rates from Barrett's esophagus to esophageal adenocarcinoma with known national cancer data. A Monte Carlo simulation, with 10,000 iterations, was conducted to derive error margins. Estimates of age-specific and overall prevalence of Barrett's esophagus in the population were generated through a similar process. Results: The lifetime risk of esophageal cancer and adenocarcinoma in USA non-Hispanic White population was 0.56% and 0.36%, respectively, while it was somewhat higher at 0.81% and 0.61% (range 0.57%-0.65%) in the Australian population. Estimated overall prevalence of Barrett's esophagus was ~3% (±0.3%) and ~ 5.4% (±0.6%) in USA White and Australian populations (male and female). Prevalence for age brackets was estimated at 0.06% (±0.02%), 1.6% (±0.7%), 3.2% (±1.3%), 8% (±3%), and 12% (±4%) for USA, and 0.05% (±0.02%), 0.9% (±0.5%), 2.8% (±1.2%), 7% (±3%), and 12% (±4%) for Australian population for ages 0-29, 30-44, 45-59, 60-74, and 75+, respectively. Observed estimates of Barrett's esophagus prevalence are likely lower than projected overall prevalence. This study also presents age-specific prevalence estimates of Barrett's esophagus, which are key in developing screening programs for esophageal adenocarcinoma.</p>","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":"38 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}