Barrett’s esophagus: novel strategies for screening and surveillance

Sanghi, Vedha; Thota, Prashanthi N.

doi:10.1177/2040622319837851

Cited by 31 publications

(45 citation statements)

References 96 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Estimates have suggested that BE are attributable to a large number of risk factors, such as chronic gastroesophageal reflux disease symptoms, advancing age, male gender, and tobacco use [6,7]. In recent years, scholars have paid considerable attention to the association between BE risk and abdominal obesity (AO), metabolic syndrome (MetS), insulin resistance (IR), and the microbiome [8][9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

A Meta-Analysis of the Impact of Obesity, Metabolic Syndrome, Insulin Resistance, and Microbiome on the Diagnosis of Barrett’s Esophagus

Jia

Cheng

Chang

et al. 2019

Dig Dis

View full text Add to dashboard Cite

Background and Aim: The etiology and pathogenesis of Barrett's esophagus (BE) have been widely studied during recent decades. However, the association between BE and possible risk factors, including abdominal obesity (AO), metabolic syndrome (MetS), insulin resistance (IR), and the microbiome has not reached a consensus and lacks a systematic assessment. The purpose of our study is to evaluate, quantify, and summarize the association between these factors and BE risk. Methods: A systematic search of Pubmed, Embase, and Cochrane Library databases was performed to identify relevant studies before September 2018. Studies were estimated with the OR, the weighted mean difference (WMD), and the 95% CI by using a random effects model. Subgroup analysis and publication bias were also performed. Results: A total of 46 citations were included in the analysis, and 119,273 subjects were analyzed (AO 13, MetS 15, IR 9, and microbiome: 9). The pooled results showed that AO (p < 0.01, OR 1.30, 95% CI 1.11-1.52, I 2 = 31.9%), MetS (p < 0.01, OR 1.68, 95% CI 1.40-2.01, I 2 = 87.6%), and IR (p < 0.01, WMD 0.23, 95% CI 0.11-0.35, I 2 = 55.8%) were all significantly associated with an increased risk of BE, but except for the mi-crobiome (p > 0.05, OR 1.27, 95% CI 0.66-2.43, I 2 = 46.7%). In addition, subgroup analyses were stratified by waist-to-hip ratio, waist circumference, body mass index, diagnosis criteria, strain type, geographical region, and study design, respectively. Moreover, we observed no evidence of publication bias in Egger's and Begg's tests. Conclusions: Our study reveals that AO, MetS, and IR are significantly associated with BE risk, except for the microbiome. The mechanism of BE induced by 3 risk factors should be further explored.

show abstract

Section: Introductionmentioning

confidence: 99%

A Meta-Analysis of the Impact of Obesity, Metabolic Syndrome, Insulin Resistance, and Microbiome on the Diagnosis of Barrett’s Esophagus

Jia

Cheng

Chang

et al. 2019

Dig Dis

View full text Add to dashboard Cite

show abstract

“…There was little difference in the incidence rates of EAC, BE and dysplasia using alternative screening methods. Although EGD with biopsy is considered the gold standard for the diagnosis and surveillance of BE [96,97], the results from these studies may encourage increased usage of alternative methods of screening for BE and EAC. Conventional EGD uses sedation, which increases the cost of screening (e.g.…”

Section: Discussionmentioning

confidence: 99%

Screening for esophageal adenocarcinoma and precancerous conditions (dysplasia and Barrett’s esophagus) in patients with chronic gastroesophageal reflux disease with or without other risk factors: two systematic reviews and one overview of reviews to inform a guideline of the Canadian Task Force on Preventive Health Care (CTFPHC)

et al. 2020

View full text Add to dashboard Cite

Background: Two reviews and an overview were produced for the Canadian Task Force on Preventive Health Care guideline on screening for esophageal adenocarcinoma in patients with chronic gastroesophageal reflux disease (GERD) without alarm symptoms. The goal was to systematically review three key questions (KQs): (1) The effectiveness of screening for these conditions; (2) How adults with chronic GERD weigh the benefits and harms of screening, and what factors contribute to their preferences and decision to undergo screening; and (3) Treatment options for Barrett's esophagus (BE), dysplasia or stage 1 EAC (overview of reviews). Methods: Bibliographic databases (e.g. Ovid MEDLINE®) were searched for each review in October 2018. We also searched for unpublished literature (e.g. relevant websites). The liberal accelerated approach was used for title and abstract screening. Two reviewers independently screened full-text articles. Data extraction and risk of bias assessments were completed by one reviewer and verified by another reviewer (KQ1 and 2). Quality assessments were completed by two reviewers independently in duplicate (KQ3). Disagreements were resolved through discussion. We used various risk of bias tools suitable for study design. The GRADE framework was used for rating the certainty of the evidence.

show abstract

“…Alexander et al [80] commented that although brush cytology compliments histology there is an added increased cost with no true improvement. Standard OGD is expensive and associated with a small risk of complications such as bleeding, perforation, aspiration and cardiopulmonary events [81]. Since OGD is not a suitable method for screening of large populations there exists a need for alternative, cheap, widely available, and an accurate method of screening [82].…”

Section: Screeningmentioning

confidence: 99%

Towards screening Barrett’s oesophagus: current guidelines, imaging modalities and future developments

Maitra

Date

Martin³

2020

Clin J Gastroenterol

View full text Add to dashboard Cite

Barrett’s oesophagus is the only known precursor to oesophageal adenocarcinoma (OAC). Although guidelines on the screening and surveillance exist in Barrett’s oesophagus, the current strategies are inadequate. Oesophagogastroduodenoscopy (OGD) is the gold standard method in screening for Barrett’s oesophagus. This invasive method is expensive with associated risks negating its use as a current screening tool for Barrett’s oesophagus. This review explores current definitions, epidemiology, biomarkers, surveillance, and screening in Barrett’s oesophagus. Imaging modalities applicable to this condition are discussed, in addition to future developments. There is an urgent need for an alternative non-invasive method of screening and/or surveillance which could be highly beneficial towards reducing waiting times, alleviating patient fears and reducing future costs in current healthcare services. Vibrational spectroscopy has been shown to be promising in categorising Barrett’s oesophagus through to high-grade dysplasia (HGD) and OAC. These techniques need further validation through multicentre trials.

show abstract

Barrett’s esophagus: novel strategies for screening and surveillance

Cited by 31 publications

References 96 publications

A Meta-Analysis of the Impact of Obesity, Metabolic Syndrome, Insulin Resistance, and Microbiome on the Diagnosis of Barrett’s Esophagus

A Meta-Analysis of the Impact of Obesity, Metabolic Syndrome, Insulin Resistance, and Microbiome on the Diagnosis of Barrett’s Esophagus

Towards screening Barrett’s oesophagus: current guidelines, imaging modalities and future developments

Contact Info

Product

Resources

About