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Visc Med

Title:		Barrett's Oesophagus: Today's Mistake and Tomorrow's Wisdom in Screening and Prevention
Author(s):		Tan WK; di Pietro M;
Address:		"MRC Cancer Unit, University of Cambridge, Cambridge, United Kingdom. Department of Gastroenterology, Addenbrookes Hospital, Cambridge University NHS Foundation Trust, Cambridge, United Kingdom. Deparment of Gastroenterology and Hepatology, Hinchingbrooke Hospital, North West Anglia NHS Foundation Trust, Huntingdon, United Kingdom"
Journal Title:		Visc Med
Year:		2022
Volume:		20220225
Issue:		3
Page Number:		161 - 167
DOI:		10.1159/000522015
ISSN/ISBN:		2297-4725 (Print) 2297-475X (Electronic) 2297-4725 (Linking)
Abstract:		"BACKGROUND: Oesophageal adenocarcinoma (OAC) is a lethal cancer with an overall 5-year survival of <20%. Given the presence of a pre-invasive disease stage, also known as Barrett's oesophagus (BO), and the availability of minimally invasive treatments for BO-related neoplasia, it is thought that early detection is the best strategy to improve patient outcomes. Clinical guidelines recommend endoscopic screening in patients with symptoms of acid reflux and additional risk factors. This strategy is flawed by the cost and invasiveness of endoscopy as well as by the fact that a significant proportion of OAC patients deny a history of reflux symptoms. SUMMARY: New research on the use of epidemiologic and clinical data has allowed the creation of risk-prediction algorithms to identify the population at risk. In addition, newer less-invasive devices such as transnasal endoscopy, Cytosponge, volumetric laser endomicroscopy, and volatile organic compounds are emerging as promising options to allow screening in the primary care setting. Finally, there is an opportunity to intervene at the pre-invasive stage with pharmacological strategies to reduce the risk burden. KEY MESSAGES: In this review, we provide a critical appraisal of the different screening approaches and chemopreventive strategies and a guide to readers on how to implement research evidence in clinical practice"
Keywords:		Barrett's oesophagus Endoscopy Oesophageal adenocarcinoma Prevention Screening;
Notes:		"PubMed-not-MEDLINETan, W Keith di Pietro, Massimiliano eng Review Switzerland 2022/07/12 Visc Med. 2022 Jun; 38(3):161-167. doi: 10.1159/000522015. Epub 2022 Feb 25"