Prevalence of precancerous and other metaplasia in the distal oesophagus and gastro-oesophageal junction

Johansson, Johan; Håkansson, Hans-Olof; Mellblom, Lennart; Kempas, Antti; Johansson, Karl‐Erik; Granath, Fredrik; Nyrén, Olof

doi:10.1080/00365520510015692

Cited by 59 publications

(51 citation statements)

References 25 publications

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“…BE has been detected in ∼ 15% of patients with chronic GERD ( 26 ) and in ∼ 1-2% of population subjects ( Table 2 ) ( 27,28 ). In a population-based study from Sweden, the authors found that severe and chronic GERD were risk factors for the development of EAC; however, 40% of the cohort with esophageal cancer reported no prior history of GERD symptoms ( 29 ).…”

Section: Summary Of Evidencementioning

confidence: 99%

ACG Clinical Guideline: Diagnosis and Management of Barrett’s Esophagus

Shaheen

Falk

Iyer

et al. 2016

American Journal of Gastroenterology

1,335

1,412

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Recent population studies suggest that gastroesophageal refl ux disease (GERD) is increasing in prevalence, both in the United States and worldwide ( 1,2 ). Th e diagnosis of GERD is associated with a 10-15% risk of Barrett's esophagus (BE), a change of the normal squamous epithelium of the distal esophagus to a columnar-lined intestinal metaplasia (IM). Risk factors associated with the development of BE include long-standing GERD, male gender, central obesity ( 3 ), and age over 50 years ( 4,5 ). Th e goal of a screening and surveillance program for BE is to identify individuals at risk for progression to esophageal adenocarcinoma (EAC), a malignancy that has been increasing in incidence since the 1970s ( 6,7 ).Th e purpose of this guideline is to review the defi nition and epidemiology of BE, available screening modalities for BE detection, rationale and methods for surveillance, and available treatment modalities including medical, endoscopic, and surgical techniques. In order to evaluate the level of evidence and strength of recommendations, we used the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system ( 8 ). Th e level of evidence ranged from "high" (implying that further research was unlikely to change the authors' confi dence in the estimate of the eff ect) to "moderate" (further research would be likely to have an impact on the confi dence in the estimate of eff ect) to "low" (further research would be expected to have an important impact on the confi dence in the estimate of the eff ect and would be likely to change the estimate) or "very low" (any estimate of eff ect is very uncertain). Th e strength of a recommendation was graded as "strong" when the desirable eff ects of an intervention clearly outweighed the undesirable eff ects and as "conditional" when there was uncertainty about the tradeoff s. We used meta-analyses or systematic reviews when available, followed by clinical trials and cohort and case-control studies. In order to determine the level Barrett's esophagus (BE) is among the most common conditions encountered by the gastroenterologist. In this document, the American College of Gastroenterology updates its guidance for the best practices in caring for these patients. These guidelines continue to endorse screening of high-risk patients for BE; however, routine screening is limited to men with refl ux symptoms and multiple other risk factors. Acknowledging recent data on the low risk of malignant progression in patients with nondysplastic BE, endoscopic surveillance intervals are attenuated in this population; patients with nondysplastic BE should undergo endoscopic surveillance no more frequently than every 3-5 years. Neither routine use of biomarker panels nor advanced endoscopic imaging techniques (beyond high-defi nition endoscopy) is recommended at this time. Endoscopic ablative therapy is recommended for patients with BE and high-grade dysplasia, as well as T1a esophageal adenocarcinoma. Based on recent level 1 evidence, endoscopic ablative therapy is ...

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Section: Summary Of Evidencementioning

confidence: 99%

ACG Clinical Guideline: Diagnosis and Management of Barrett’s Esophagus

Shaheen

Falk

Iyer

et al. 2016

American Journal of Gastroenterology

1,335

1,412

View full text Add to dashboard Cite

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“…Öberg et al [28] and Csendes et al [7] recently reported presence of IM within endoscopic short-segment CLE of 30.5% and 35%, respectively. In investigation of individuals with and without GERD symptoms, Johansson et al [29] recently found the incidence of IM in the absence and presence of endoscopically visible CLE to be 12% and 36%, respectively. Thus the data obtained in our study are in line with recent reports.…”

Section: Discussionmentioning

confidence: 97%

Histopathology of columnar-lined esophagus in patients with gastroesophageal reflux disease

Lenglinger¹,

Ringhofer²,

Eisler³

et al. 2007

Wien Klin Wochenschr

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“…Presence of IM within endoscopic short-segment CLE (≤ 3cm) has been variously reported to be 13% [42], 30.5% [12] and 35% [28]. Johansson et al [43] recently reported the incidence of IM in the absence and presence of endoscopically visible CLE as 12% and 36%, respectively. Lenglinger et al [21] recently found IM in 27.5% of GERD patients with CLE < 3 cm.…”

Section: Discussionmentioning

confidence: 98%

Videoendoscopy and histopathology of the esophagogastric junction in patients with gastroesophageal reflux disease

Ringhofer¹,

Lenglinger²,

Eisler³

et al. 2007

Wien Klin Wochenschr

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Prevalence of precancerous and other metaplasia in the distal oesophagus and gastro-oesophageal junction

Abstract: While BO is not common among Swedish gastroscopy patients, IM and PAM are found in every 7th and 6th patient, respectively. Age-dependent increments in prevalence suggest that not only BO and IM, but also cardia-type mucosa are acquired and/or progressive lesions.

Cited by 59 publications

References 25 publications

ACG Clinical Guideline: Diagnosis and Management of Barrett’s Esophagus

ACG Clinical Guideline: Diagnosis and Management of Barrett’s Esophagus

Histopathology of columnar-lined esophagus in patients with gastroesophageal reflux disease

Videoendoscopy and histopathology of the esophagogastric junction in patients with gastroesophageal reflux disease

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