The researchers determined the preoperative prevalence of Barrett's esophagus in reported cases of incident esophageal adenocarcinoma undergoing resection.
This was used as an indirect measure of the public health impact of past screening and surveillance practices on the outcomes of Barrett's related cancers.
The findings of the study were published in the January 2002 issue of Gastroenterology.
The team conducted a systematic review of the literature from 1966 to 2000.
Studies were included if they reported both the number of consecutive adenocarcinomas resected, and the number of those resected who had a previously known diagnosis of Barrett's.
| Just 5% of adenocarcinoma resection patients had prior diagnosis of Barrett's.
| Gastroenterology |
A total of 752 studies were identified and reviewed. Of these, 12 studies, representing a total of 1503 unique cases of resected adenocarcinomas, met inclusion criteria.
Using a random effects model, the overall percentage of patients undergoing resection who had a prior diagnosis of Barrett's was found to be 4.7%.
Gareth S. Dulai, of the UCLA School of Medicine, Los Angeles, said on behalf of his colleagues, "There was a low prior prevalence of Barrett's esophagus in this study population. This provides indirect evidence to suggest that recent efforts to identify patients with Barrett's - whether through endoscopic screening or evaluation of symptomatic patients - have had minimal public health impact on esophageal adenocarcinoma outcomes.
"The potential benefits of endoscopic surveillance seem to have been limited to only a fraction of those individuals at risk.
"These data thus provide a clear and compelling rationale for the development of effective screening strategies to identify patients with Barrett's esophagus," it was concluded.