The Perception of Cancer Risk in Patients With Prevalent Barrett’s Esophagus Enrolled in an Endoscopic Surveillance Program

Shaheen, Nicholas J.; GREEN, B; Medapalli, Raj K.; Mitchell, Kate; Wei, Jintao; Schmitz, Sarah; West, Lindsay; Brown, Alphonso; Noble, Marc D.; Sultan, Shahnaz

doi:10.1016/j.gastro.2005.05.055

Cited by 95 publications

(52 citation statements)

References 31 publications

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“…Patients with Barrett's esophagus appear to greatly overestimate their cancer risk, and this overestimation is associated with an increase in their utilization of health care. 41 In addition to this psychological distress, patients with Barrett's esophagus face higher individual costs for life insurance and may be unable to obtain health insurance. 42 …”

Section: Agai Procedures For Construction Of Technical Reviewsmentioning

confidence: 99%

American Gastroenterological Association Technical Review on the Management of Barrett's Esophagus

Spechler¹,

Sharma

Souza³

et al. 2011

Gastroenterology

1,006

676

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Section: Agai Procedures For Construction Of Technical Reviewsmentioning

confidence: 99%

American Gastroenterological Association Technical Review on the Management of Barrett's Esophagus

Spechler¹,

Sharma

Souza³

et al. 2011

Gastroenterology

1,006

676

View full text Add to dashboard Cite

“…3 More recent studies based on large population-based pathology registries have shown the risk to be lower. 4 It is also well known that patients tend to overestimate their risk of progression, 5 which leads to overutilization of surveillance. 6 …”

Section: Introductionmentioning

confidence: 99%

Diagnosis and Management of Barrett's Esophagus

Nelsen

Hawes

Iyer

2012

Surgical Clinics of North America

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“…There are no large-scale studies from community or healthcare system based settings documenting the use of screening or surveillance endoscopy among well-defined populations. Studies evaluating patients’ perceptions of cancer risk and acceptability of endoscopic surveillance for BE, and predictors of adherence to surveillance endoscopy demonstrate poor understanding of the available evidence and utilization that is driven by insurance type and availability of endoscopy services [17-22]. …”

Section: Introductionmentioning

confidence: 99%

“…Most patients with BE incorrectly estimate their risk of EA. Shaheen et al performed a study evaluating the risk perceptions for progression to EA among 118 patients with non-dysplastic BE undergoing surveillance endoscopy [22]. The study, which used a visual analog scale that was developed to factor low incidence risks [23], found that 68% of respondents over-estimated their 1-year risk of cancer (13.6% versus an actual risk of 0.05%) [22].…”

Section: Introductionmentioning

confidence: 99%

“…Shaheen et al performed a study evaluating the risk perceptions for progression to EA among 118 patients with non-dysplastic BE undergoing surveillance endoscopy [22]. The study, which used a visual analog scale that was developed to factor low incidence risks [23], found that 68% of respondents over-estimated their 1-year risk of cancer (13.6% versus an actual risk of 0.05%) [22]. In contrast, a Dutch study of 192 patients with BE and no high-grade dysplasia found that participants underestimated their 1-year risk of cancer [21].…”

Section: Introductionmentioning

confidence: 99%

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Patient-centered, comparative effectiveness of esophageal cancer screening: protocol for a comparative effectiveness research study to inform guidelines for evidence-based approach to screening and surveillance endoscopy

Kramer

Arney

Chen

et al. 2012

BMC Health Serv Res

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BackgroundThe comparative effectiveness (CE) of endoscopic screening (versus no screening) for Barrett’s esophagus (BE) in patients with GERD symptoms, or among different endoscopic surveillance strategies in patients with BE, for the early detection of esophageal adenocarcinoma (EA) is unknown. Furthermore, it is unclear if patients or providers have or will adopt any of these strategies (screening only, screening and surveillance, vs. none), irrespective of their effectiveness. Endoscopic screening and surveillance is expensive and can be risky. Therefore, it is imperative to establish the CE and acceptability about the risks and outcomes related to these practices to better inform expert recommendations and provider-patient decisions.Methods/ResultsWe propose a mixed methods study which will involve: (1) an analysis of secondary databases (VA and VA-Medicare linked datasets for 2004–09) to examine CE of endoscopic screening and surveillance in an observational study cohort (an estimated 680,000 patients with GERD; 25,000–30,000 with BE; and 3,000 with EA); (2) a structured electronic medical record (EMR) review on a national sample of patients using VA EMRs to verify all EA cases, identify cancer stage, cancer-targeted therapy, and validate the screening and surveillance endoscopy; and (3) qualitative in depth interviews with patients and providers to elicit preferences, norms, and behaviors to explain clinical contexts of these findings and address gaps arising from the CE study.ConclusionThis study will compare clinical strategies for detecting and monitoring BE, a pre-cancerous lesion. Additionally, by eliciting acceptability of these strategies for patients and providers, we will be able to propose effective and feasible strategies that are likely to be implemented in routine use. Findings will inform recommendations for clinical practice guidelines. Our innovative approach is consistent with the methodological standards of patient-centered outcomes research, and our findings will offer a significant contribution to the literature on cancer surveillance.Trial RegistrationNot applicable

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The Perception of Cancer Risk in Patients With Prevalent Barrett’s Esophagus Enrolled in an Endoscopic Surveillance Program

Cited by 95 publications

References 31 publications

American Gastroenterological Association Technical Review on the Management of Barrett's Esophagus

American Gastroenterological Association Technical Review on the Management of Barrett's Esophagus

Diagnosis and Management of Barrett's Esophagus

Patient-centered, comparative effectiveness of esophageal cancer screening: protocol for a comparative effectiveness research study to inform guidelines for evidence-based approach to screening and surveillance endoscopy

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