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One-Fourth of Esophageal Cancers Among Those With BE Missed in Year Before Diagnosis

Authors say there is need to improve effectiveness of screening and surveillance practices for early cancer detection in patients with Barrett esophagus

By Lori Solomon HealthDay Reporter

FRIDAY, Aug. 4, 2023 (HealthDay News) — Nearly one-quarter of Barrett esophagus patients with esophageal adenocarcinoma (EAC) had normal endoscopic screenings within the prior year, according to a study published online June 4 in Gastroenterology.

Sachin Wani, M.D., from the University of Colorado Anschutz Medical Center in Aurora, and colleagues examined associations between postendoscopy esophageal adenocarcinoma (PEEC) and postendoscopy esophageal neoplasia (PEEN) outcomes with Barrett esophagus. The analysis included 20,588 patients with newly diagnosed Barrett esophagus in Nordic countries.

The researchers found that among the 293 patients diagnosed with EAC, 23.5 percent were categorized as PEEC, 14.7 percent as index EAC, and 61.8 percent as incident EAC. For PEEC and incident EAC, the incident rates were 392 and 208 per 100,000 person-years, respectively. Among the 279 patients diagnosed with high-grade dysplasia (HGD)/EAC, 17.2 percent were PEEN, 14.6 percent were index HGD/EAC, and 68.1 percent were incident HGD/EAC, with incident rates of 421 per 100,000 person-years for PEEN and 285 for incident HGD/EAC. Results were similar in sensitivity analyses that varied time interval for occurrence of PEEC/PEEN. A time-trend analysis for incident rates showed increasing incidence rates of PEEC/PEEN.

“Almost a quarter of all EACs are detected within a year after an ostensibly negative upper endoscopy in patients with newly diagnosed Barrett esophagus,” the authors write. “Interventions to improve detection may reduce PEEC/PEEN rates.”

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