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[Revision needed of follow-up policy for Barrett's esophagus].
- Source :
-
Nederlands tijdschrift voor geneeskunde [Ned Tijdschr Geneeskd] 2002 Jan 26; Vol. 146 (4), pp. 150-4. - Publication Year :
- 2002
-
Abstract
- The frequency of adenocarcinomas at the oesophagocardial junction is increasing and, if symptomatic, the patients chances of cure are bleak. Given the association of Barrett's oesophagus (Barrett's oesophagus; denoting metaplasia of the oesophageal squamous cell lining to gastric-type mucosa) and oesophageal adenocarcinoma, it is plausible that establishing the presence of Barrett's oesophagus will subsequently enable two preventive strategies: primary, i.e. the treatment and eradication of Barrett's oesophagus, and secondary, the early diagnosis of (pre)malignancy during periodic endoscopic follow-up. Given the frequent occurrence of Barrett's oesophagus and the rarity of oesophageal adenocarcinoma there is a clear risk of overdiagnosis and overtreatment. Most studies on the effect of regular follow-up are uncontrolled and barely give any indication of a favourable outcome. Only a minority of patients with Barrett's oesophagus ought to have periodic endoscopic checkups: those with dysplasia or with one or more of the known risk factors (especially male gender, specialised type Barrett's oesophagus and long segment Barrett's oesophagus). Those patients must be healthy enough beforehand to undergo surgical treatment if necessary. The amount of quantity or quality of life that may be gained from this approach has yet to be established.
- Subjects :
- Adenocarcinoma diagnosis
Adenocarcinoma etiology
Adult
Barrett Esophagus complications
Barrett Esophagus epidemiology
Diagnosis, Differential
Disease Management
Esophageal Neoplasms diagnosis
Esophageal Neoplasms etiology
Esophagoscopy
Female
Humans
Male
Netherlands epidemiology
Practice Guidelines as Topic
Risk Factors
Adenocarcinoma prevention & control
Barrett Esophagus diagnosis
Barrett Esophagus therapy
Esophageal Neoplasms prevention & control
Subjects
Details
- Language :
- Dutch; Flemish
- ISSN :
- 0028-2162
- Volume :
- 146
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Nederlands tijdschrift voor geneeskunde
- Publication Type :
- Academic Journal
- Accession number :
- 11845562