Esophageal cancer screening
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Esophageal cancer Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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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, men over the age of 50 years should have random endoscopic biopsies taken in all 4 quadrants with a high resolution endoscope.
- Most dysplastic changes are found in white men that are older than 50 years of age.
- It should also be noted that those who presented with adenocarcinoma demonstrated no prior Barrett's esophagus in 80 - 90% of the time.
- 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
Squamous cell carcinoma of the esophagus is more prevalent in underdeveloped countries; there is no reliable data to suggest that screening programs are effective when implemented.
- In China, esophageal cancer is the sixth most common cancer and the fourth most common cause of death from cancer.
- A screening program in a high risk population (in China) was put into effect where those with mild to moderate dysplasia were examined via endoscopy every 3 years, whilst those with severe dysplasia were screened once per year.
- The patients with dysplasia were concomitantly treated with monoclonal antibodies for the next three years.
- At the end of three year monoclonal antibody trial the incidence rate of esophageal squamous cell carcinoma 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.