Screening for esophageal adenocarcinoma: An evidence-based approach
Screening for esophageal adenocarcinoma: An evidence-based approach
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DOI：
10.1016/s0002-9343(02)01234-2
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发表时间：
2002-10-15
影响因子：
5.9
通讯作者：
Triadafilopoulos, G
中科院分区：
文献类型：
--
作者：
Gerson, LB;Triadafilopoulos, G
食管和胃食管交界处腺癌是美国第二十常见的恶性肿瘤。在发达国家，食管腺癌的发病率每年增加5%至10%。尽管使用内窥镜进行早期检测，食管腺癌的死亡率并没有下降，我们回顾了食管腺癌的筛查方法，包括使用症状问卷，识别有Barrett食管家族史的患者，经口或经鼻内窥镜检查，钡吞，粪便潜血试验，刷和气球细胞学。筛查尚未显示出降低Barrett食管进展为食管癌的速度。对于发育不良的Barrett食管或早期癌，许多治疗方案似乎有效，但长期随访数据不可用。目前没有足够的证据支持基于人群的Barrett食管筛查。几个危险因素，包括严重的反流症状，男性和肥胖，可能会确定胃食管反流病患者谁是在，最大的风险发展为癌症。
Adenocarcinoma of the esophagus and the gastroesophageal junction is the twentieth most common malignancy in the United States. In developed countries, the incidence of esophageal adenocarcinoma is increasing 5% to 10% per year. Despite the use of endoscopy for earlier detection, mortality from esophageal adenocarcinoma has not declined.Using an evidence-based approach, we review screening methods for esophageal adenocarcinoma, including the use of a symptom questionnaire, identification of patients with a family history of Barrett's esophagus, peroral or transnasal endoscopy, barium swallow, fecal occult blood testing, and brush and balloon cytology. Screening has not been shown to reduce rate of progression of Barrett's esophagus to esophageal cancer. Many treatment options for dysplastic Barrett's esophagus or early carcinoma appear effective, but long-term follow-up data are not available. There is currently insufficient evidence supporting population-based screening for Barrett's esophagus. Several risk factors, including severe reflux symptoms, male sex, and obesity, may identify patients with gastroesophageal reflux disease who are at, the greatest risk of the development of cancer.