It has been suggested that endoscopic cancer surveillance is beneficial to patients with Barrett's esophagus
However, only a small proportion of patients with Barrett's esophagus will die from adenocarcinoma.
Dr Sunna Gudlaugsdottir and colleagues at University Hospital, Rotterdam, the Netherlands, assessed the benefits of endoscopic cancer surveillance in 335 patients diagnosed with Barrett's esophagus at routine endoscopy.
Endoscopic cancer surveillance was said to have improved quality of life only in individuals for whom the incidence of adenocarcinoma was greater than 1 out of 200 patient years.
During a 5-year follow-up period, 75 of 335 adult patients with Barrett's esophagus died from unrelated causes, ruling them out of endoscopic cancer surveillance.
47 more patients were excluded from endoscopic cancer surveillance because they had other diseases limiting their chances of survival.
59 patients were over 75 years of age and were therefore unsuitable for further endoscopic screening.
Of the remaining patients, 197 fell in low-risk groups, including all women, men under 60 years old, and men with Barrett's esophagus of less than 3cm in length.
These low-risk patients would not benefit from endoscopic cancer screening, because adenocarcinomas would occur less than once every 200 patient years.
|Only 15.5% of patients in the study were eligible for endoscopic cancer surveillance.
|European Journal of Gastroenterology and Hepatology|
Only 32 of the original 335 patients (15.5%) were eligible for endoscopic cancer surveillance.
Dr Gudlaugsdottir concludes, "Prospective surveillance programs should be limited to patients with an increased cancer risk and a good health profile."