Nonendoscopic Detection of Barrett Esophagus and Esophageal Adenocarcinoma: Recent Advances and Implications
Authors: Prasad G. Iyer, David A. Katzka
Journal: Annals of Internal Medicine (2021)

Ideas and OpinionsJuly 2021Nonendoscopic Detection of Barrett Esophagus and Esophageal Adenocarcinoma: Recent Advances and ImplicationsPrasad G. Iyer, MD, MSc and David A. Katzka, MDPrasad G. Iyer, MD, MScMayo Clinic, Rochester, Minnesota (P.G.I., D.A.K.). and David A. Katzka, MDMayo Clinic, Rochester, Minnesota (P.G.I., D.A.K.).Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M20-7164 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Esophageal adenocarcinoma (EAC) is a lethal form of cancer with poor prognosis (5-year survival ≤20% when diagnosed after the onset of symptoms), and its incidence has rapidly increased over the last 4 decades (1). Barrett esophagus (BE), a metaplastic change of the esophageal squamous to intestinalized columnar epithelium, is the only known precursor for EAC. In some individuals, BE may progress to EAC through the development of low- and high-grade dysplasia. Endoscopic therapy for dysplasia can reduce the risk for progression to EAC, and endoscopic treatment of early-stage EAC is associated with excellent long-term survival. Therefore, consideration of endoscopic screening ...References1. Codipilly DC, Sawas T, Dhaliwal L, et al. Epidemiology and outcomes of young-onset esophageal adenocarcinoma: an analysis from a population-based database. Cancer Epidemiol Biomarkers Prev. 2021;30:142-149. [PMID: 33328255] doi:10.1158/1055-9965.EPI-20-0944 CrossrefMedlineGoogle Scholar2. Shaheen NJ, Weinberg DS, Denberg TD, et al; Clinical Guidelines Committee of the American College of Physicians. Upper endoscopy for gastroesophageal reflux disease: best practice advice from the clinical guidelines committee of the American College of Physicians. Ann Intern Med. 2012;157:808-816. [PMID: 23208168] doi:10.7326/0003-4819-157-11-201212040-00008 LinkGoogle Scholar3. Codipilly DC, Chandar AK, Singh S, et al. The effect of endoscopic surveillance in patients with Barrett's esophagus: a systematic review and meta-analysis. Gastroenterology. 2018;154:2068-2086.e5. [PMID: 29458154] doi:10.1053/j.gastro.2018.02.022 CrossrefMedlineGoogle Scholar4. Jung KW, Talley NJ, Romero Y, et al. Epidemiology and natural history of intestinal metaplasia of the gastroesophageal junction and Barrett's esophagus: a population-based study. Am J Gastroenterol. 2011;106:1447-1455. [PMID: 21483461] doi:10.1038/ajg.2011.130 CrossrefMedlineGoogle Scholar5. Iyer PG, Taylor WR, Johnson ML, et al. Accurate nonendoscopic detection of Barrett's esophagus by methylated DNA markers: a multisite case control study. Am J Gastroenterol. 2020;115:1201-1209. [PMID: 32558685] doi:10.14309/ajg.0000000000000656 CrossrefMedlineGoogle Scholar6. Ross-Innes CS, Debiram-Beecham I, O’Donovan M, et al; BEST2 Study Group. Evaluation of a minimally invasive cell sampling device coupled with assessment of trefoil factor 3 expression for diagnosing Barrett's esophagus: a multi-center case-control study. PLoS Med. 2015;12:e1001780. [PMID: 25634542] doi:10.1371/journal.pmed.1001780 CrossrefMedlineGoogle Scholar7. Moinova HR, LaFramboise T, Lutterbaugh JD, et al. Identifying DNA methylation biomarkers for non-endoscopic detection of Barrett's esophagus. Sci Transl Med. 2018;10. [PMID: 29343623] doi:10.1126/scitranslmed.aao5848 CrossrefMedlineGoogle Scholar8. Heberle CR, Omidvari AH, Ali A, et al. Cost effectiveness of screening patients with gastroesophageal reflux disease for Barrett's esophagus with a minimally invasive cell sampling device. Clin Gastroenterol Hepatol. 2017;15:1397-1404.e7. [PMID: 28238953] doi:10.1016/j.cgh.2017.02.017 CrossrefMedlineGoogle Scholar9. Fitzgerald RC, di Pietro, O’Donovan M, et al; BEST3 Trial team. Cytosponge-trefoil factor 3 versus usual care to identify Barrett's oesophagus in a primary care setting: a multicentre, pragmatic, randomised controlled trial. Lancet. 2020;396:333-344. [PMID: 32738955] doi:10.1016/S0140-6736(20)31099-0 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Mayo Clinic, Rochester, Minnesota (P.G.I., D.A.K.).Financial Support: Partially supported by a National Cancer Institute R01 grant (CA 241164) to Dr. Iyer.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M20-7164.Corresponding Author: Prasad G. Iyer, MD, MSc, Professor of Medicine, Division of Gastroenterology and Hepatology Mayo Clinic, 200 1st Street SW, Rochester, MN 55905; e-mail, iyer.[email protected]edu.Current Author Addresses: Drs. Iyer and Katzka: Division of Gastroenterology and Hepatology Mayo Clinic, 200 1st Street SW, Rochester, MN 55905.Author Contributions: Conception and design: P.G. Iyer.Analysis and interpretation of the data: P.G. Iyer.Drafting of the article: P.G. Iyer, D.A. Katzka.Critical revision for important intellectual content: P.G. Iyer, D.A. Katzka.Final approval of the article: P.G. Iyer, D.A. Katzka.Obtaining of funding: P.G. Iyer.This article was published at Annals.org on 4 May 2021. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics July 2021Volume 174, Issue 7Page: 1006-1007 ePublished: 4 May 2021 Issue Published: July 2021 Copyright & PermissionsCopyright © 2021 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...