Patients with Barrett's esophagus have a risk of esophageal adenocarcinoma of approximately 0.5% per year.
Patients may have difficulty understanding this risk.
Dr Nicholas Shaheen and colleagues from North Carolina assessed the perceived risk of cancer in patients with Barrett's esophagus.
The investigators correlated the patients' risk estimates with their health care use behaviors.
The investigative team performed a survey of patients with Barrett's esophagus participating in an endoscopic surveillance program at 2 sites.
The 2 research sites included a university teaching hospital and a Veterans' Administration hospital.
A questionnaire also elicited their demographics as well as their sources of health information.
The investigators assessed health care behaviors, including physician visits, endoscopic surveillance behaviours, and characteristics of overestimators.
|68% of patients overestimated their 1-year risk of cancer|
Patients were classified as either overestimators or nonoverestimators of risk.
The investigative team reported that 118 patients met entry criteria, and 78% completed all the questionnaires.
The team found that 68% of patients overestimated their 1-year risk of cancer, with a mean estimated 1-year cancer risk being 14%.
The lifetime risk also was overestimated by 38% of patients.
The team observed that patients who overestimated risk were more likely to be Veterans' Administration medical center patients.
In addition, the team noted that these patients have more symptomatic reflux, and were more likely to use the Internet to get health care information.
There was no significant difference in physician visits between overestimators and nonestimators.
The investigators observed a similar rate of endoscopy use between overestimators and nonestimators at 6 per 5-year period vs 5, respectively.
Dr Shaheen's team concludes, “The majority of patients with prevalent Barrett's esophagus participating in an endoscopic surveillance program overestimated their chances of developing adenocarcinoma of the esophagus.”
“Efforts to improve education of such patients with Barrett's esophagus are warranted.”