The team evaluated the association between endoscopic surveillance of Barrett's esophagus and survival among esophageal and gastric cardia adenocarcinoma patients.
They published their data in the March issue of Gastroenterology.
Among 589 esophageal or gastric cardia adenocarcinoma patients diagnosed between 1990 and 1998 at Northern California Kaiser Permanente, a cohort of 23 Barrett's patients was studied.
The presence of Barrett's, detection of cancer by endoscopic surveillance, cancer stage, mortality, and potential confounders were measured.
Barrett's was diagnosed in 135 of 589 adenocarcinoma patients, with 23 of these patients diagnosed more than 6 months before cancer was diagnosed.
Among the 23 patients, 73% of the surveillance-detected cancer patients (n = 15) were alive at the end of follow-up, compared with none of the patients without surveillance-detected cancers (n = 8).
All surveillance-detected cancer patients had low-stage disease and none died directly from cancer.
The researchers found that the surveillance/survival association was not substantially altered by stratification for age at Barrett's diagnosis or other potential confounders.
|Cancer patients alive at end of follow-up:|
Not surveillance-detected: 0%
| Gastroenterology |
Douglas A. Corley, of the University of California, Berkeley, said on behalf of his colleagues, "Surveillance-detected Barrett's-associated adenocarcinomas were associated with low-stage disease and improved survival.
"Additional studies are needed to evaluate potential biases and whether screening/surveillance programs decrease mortality among all patients in surveillance."
"Few patients (4%) had Barrett's diagnosed before their cancer. Thus, even if current surveillance techniques are effective, they are unlikely to substantially impact the population's mortality from esophageal cancer.
"Better methods are needed to identify at risk patients," he concluded.