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 27 May 2018

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News

Dysplasia and cancer in patients with Barrett's esophagus

Most patients with low-grade dysplasia regress and have a cancer incidence similar to all Barrett's esophagus patients, find doctors in Clinical Gastroenterology and Hepatology.

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The exact incidence of adenocarcinoma in patients with Barrett's esophagus is not known.

In this study, doctors from the United States examined the prevalence and incidence of dysplasia and cancer in a large multicenter cohort of Barrett's esophagus patients.

The team regarded cancers and high-grade dysplasia which occurred within 12 months of the index endoscopy as prevalent cases.

Overall, 1376 patients met the study criteria (95% white, 14% women).

The incidence of low-grade dysplasia was 4% per year.
Clinical Gastroenterology and Hepatology

The team found that 91 patients had cancer at the initial endoscopy (prevalent cases = 7%).

A total of 618 patients were followed for 2546 patient-years; mean follow-up was 4.12 years.

The doctors found that 12 patients developed cancer during follow-up; a cancer incidence of 1 in 212 patient-years of follow-up. In addition, the combined incidence of high-grade dysplasia and/or cancer was 1 in 75 patient-years of follow-up.

Of the 34 patients who developed high-grade dysplasia and/or cancer, 53% had at least 2 initial consecutive endoscopies with biopsies revealing nondysplastic mucosa.

The doctors determined that the incidence of low-grade dysplasia was 4% per year.

In the 156 patients with low-grade dysplasia, regression to no dysplasia occurred in 66%. There also was persistent low-grade dysplasia in 21% and progression to high-grade dysplasia or cancer in 13%.

The incidence of cancer in patients with low-grade dysplasia was 1 in 156 patient-years of follow-up.

Dr Prateek Sharma's team concluded, "Preliminary results…define the prevalence and incidence of dysplasia and cancer in a multicenter cohort of patients with Barrett's esophagus".

"At least half the patients who developed high-grade dysplasia and/or cancer had 2 consecutive initial endoscopies with biopsies revealing nondysplastic mucosa".

"The majority of patients with low-grade dysplasia regressed and had a cancer incidence similar to all Barrett's esophagus patients".

Clin Gastroenterol Hepatol 2006; 4(5): 566-72
24 May 2006

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