Esophageal cancer screening: Difference between revisions
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==Overview== | ==Overview== | ||
Screening may be effective in reducing the incidence of esophageal cancer, especially | Screening may be effective in reducing the incidence of esophageal cancer, especially in Barrett's esophagus-associated adenocarcinoma, however, not very cost effective. | ||
==Screening== | ==Screening== | ||
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===Adenocarcinoma screening=== | ===Adenocarcinoma screening=== | ||
*The predominant type of esophageal cancer in the United States is adenocarcinoma. | *The predominant type of esophageal cancer in the United States is [[adenocarcinoma]]. | ||
*Under current guidelines, random endoscopic biopsies are taken in all 4 quadrants with a high resolution endoscope. | *Under current guidelines, random endoscopic [[Biopsy|biopsies]] are taken in all 4 quadrants with a high resolution [[Endoscopy|endoscope]]. | ||
*Dysplasia within lesions of | *[[Dysplasia]] within lesions of the [[esophagus]] indicates a marked increase in cancer risk. | ||
*It should be noted that those who presented with adenocarcinoma demonstrated no | *It should be noted that those who presented with adenocarcinoma demonstrated no prior [[Barrett's esophagus]] in 80 - 90% of the time. | ||
*Most dysplastic changes | *Most dysplastic changes are found in white men that are older than 50 years of age. | ||
* | *One study surmised that the only cost-effective strategy was once in a lifetime screening of 50+ year old, white men with GERD, followed by surveillance of those with dysplasia only.<ref name="pmid26185366">{{cite journal |vauthors=Domper Arnal MJ, Ferrández Arenas Á, Lanas Arbeloa Á |title=Esophageal cancer: Risk factors, screening and endoscopic treatment in Western and Eastern countries |journal=World J. Gastroenterol. |volume=21 |issue=26 |pages=7933–43 |year=2015 |pmid=26185366 |pmc=4499337 |doi=10.3748/wjg.v21.i26.7933 |url=}}</ref> | ||
===Squamous cell carcinoma screening=== | ===Squamous cell carcinoma screening=== | ||
*Since | *Since squamous cell carcinoma of the esophagus is prevalent more in underdeveloped countries, there is no reliable data to suggest that screening programs are effective when implemented. | ||
*However, in China, esophageal cancer is the sixth most common cancer and the fourth most common cause of death from cancer, | *However, in China, esophageal cancer is the sixth most common cancer and the fourth most common cause of death from cancer. | ||
*In China, 287,000 new cases of esophageal squamous cell carcinoma and 211,000 deaths were reported in 2012. | |||
*A screening program in a high risk population was put into effect where those with mild to moderate dysplasia are examined via endoscopy every 3 years, whilst those with severe dysplasia were screened once per year. | |||
*The patients were concomitantly treated with monoclonal antibodies for the next three years, and the incidence decreased by 57%. | |||
*These results demonstrated that the screening for esophageal squamous cell carcinoma is effective in the prevention of esophageal cancer.<ref name="pmid3219974">{{cite journal |vauthors=Lin PZ, Zhang JS, Cao SG, Rong ZP, Gao RQ, Han R, Shu SP |title=[Secondary prevention of esophageal cancer--intervention on precancerous lesions of the esophagus] |language=Chinese |journal=Zhonghua Zhong Liu Za Zhi |volume=10 |issue=3 |pages=161–6 |year=1988 |pmid=3219974 |doi= |url=}}</ref> | |||
==References== | ==References== | ||
Revision as of 19:40, 14 December 2017
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Esophageal cancer Microchapters |
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Esophageal cancer screening On the Web |
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American Roentgen Ray Society Images of Esophageal cancer screening |
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Risk calculators and risk factors for Esophageal cancer screening |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]
Overview
Screening may be effective in reducing the incidence of esophageal cancer, especially in Barrett's esophagus-associated adenocarcinoma, however, not very cost effective.
Screening
Adenocarcinoma screening
- The predominant type of esophageal cancer in the United States is adenocarcinoma.
- Under current guidelines, random endoscopic biopsies are taken in all 4 quadrants with a high resolution endoscope.
- Dysplasia within lesions of the esophagus indicates a marked increase in cancer risk.
- It should be noted that those who presented with adenocarcinoma demonstrated no prior Barrett's esophagus in 80 - 90% of the time.
- Most dysplastic changes are found in white men that are older than 50 years of age.
- One study surmised that the only cost-effective strategy was once in a lifetime screening of 50+ year old, white men with GERD, followed by surveillance of those with dysplasia only.[1]
Squamous cell carcinoma screening
- Since squamous cell carcinoma of the esophagus is prevalent more in underdeveloped countries, there is no reliable data to suggest that screening programs are effective when implemented.
- However, in China, esophageal cancer is the sixth most common cancer and the fourth most common cause of death from cancer.
- In China, 287,000 new cases of esophageal squamous cell carcinoma and 211,000 deaths were reported in 2012.
- A screening program in a high risk population was put into effect where those with mild to moderate dysplasia are examined via endoscopy every 3 years, whilst those with severe dysplasia were screened once per year.
- The patients were concomitantly treated with monoclonal antibodies for the next three years, and the incidence decreased by 57%.
- These results demonstrated that the screening for esophageal squamous cell carcinoma is effective in the prevention of esophageal cancer.[2]
References
- ↑ Domper Arnal MJ, Ferrández Arenas Á, Lanas Arbeloa Á (2015). "Esophageal cancer: Risk factors, screening and endoscopic treatment in Western and Eastern countries". World J. Gastroenterol. 21 (26): 7933–43. doi:10.3748/wjg.v21.i26.7933. PMC 4499337. PMID 26185366.
- ↑ Lin PZ, Zhang JS, Cao SG, Rong ZP, Gao RQ, Han R, Shu SP (1988). "[Secondary prevention of esophageal cancer--intervention on precancerous lesions of the esophagus]". Zhonghua Zhong Liu Za Zhi (in Chinese). 10 (3): 161–6. PMID 3219974.