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 23 May 2018

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News

Low frequency of Barrett's cancer after negative endoscopy

The risk of cancer in Barrett esophagus after an initial negative endoscopy is comparable in the USA and United Kingdom, shows December's Endoscopy.

News image

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Barrett's adenocarcinoma is being diagnosed increasingly.

Dr Vieth and colleagues from Germany examined possible differences between long segment and short-segment Barrett esophagus.

The research team evaluated this during long-term follow-up on the basis of their histopathology registry.

The team selected all 1071 Barrett's esophagus patients diagnosed histologically between 1990 and 1995.

The researchers sought long-term follow-up data from endoscopy with biopsy were in 1003 patients without neoplasia on initial endoscopic biopsy.

A total of 255 individuals were regarded as drop-outs.

The yearly incidence of Barrett esophagus cancer is about 1%
Endoscopy

Data of 201 were lost and 54 without further endoscopy.

Of the remaining 748 patients with follow up for more than 5 years, 315 had documented long segment Barrett esophagus.

The researchers found that 246 had short-segment Barrett esophagus, and 187 had no length of Barrett esophagus recorded.

In the study cases, the biopsy procedure was fully compliant with guidelines in only 33%.

The researchers observed that less than 1% had visible lesions reported on endoscopy, but all were negative for neoplasia.

Over a mean follow-up of 78 months, 7 new cases of low grade intraepithelial neoplasia, and 15 cancer cases developed.

This accounted for a yearly incidence less than 1% after an initial negative endoscopy.

When the cases with initial diagnosis of neoplasia were included, this yearly incidence rose in low grade intraepithelial neoplasia, high grade intraepithelial neoplasia and cancer.

The researchers encountered differences between short and long segment Barrett esophagus for cancer incidence.

Dr Vieth's team concludes, “The yearly incidence of Barrett esophagus cancer varies between 0.4 % and 1.7 %.”

“The observed risk of developing cancer in Barrett esophagus without neoplasia is comparable to that found in other studies, mainly from the USA and the United Kingdom.”

“The yearly incidence is about 1%.

Endoscopy 2006: 38: 1201-5
15 December 2006

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