BACKGROUND: The efficacy of screening and surveillance EGD for esophageal adenocarcinoma (EAC) is controversial. OBJECTIVE: To examine the effect of an EGD before the diagnosis of EAC on survival after the diagnosis of cancer among patients with gastroesophageal reflux (GER). DESIGN: A retrospective, controlled cohort study. SUBJECTS: The national administrative databases of the Veterans Affairs were accessed, and patients diagnosed with EAC, from 1995 through 2003, who had a prior diagnosis consistent with GER were identified. Electronic medical records were then abstracted. Cases were subjects who had an EGD performed between 1 and 5 years before the diagnosis of EAC; controls were those subjects without a prior EGD. RESULTS: A total of 155 subjects with EAC and GER were identified. Cases with a history of an EGD at least 1 year before a diagnosis of EAC (n = 25) were diagnosed at earlier stages than those without a prior EGD (P = .02) but did not experience a significant improvement in survival (adjusted hazard ratio 0.93 [95% CI, 0.58-1.50]). Cases who had been enrolled in surveillance programs that adhered to published guidelines trended toward improved survival, but long-term survival reverted toward the rate found without any surveillance. CONCLUSIONS: A prior EGD was associated with an improved stage at the diagnosis of EAC but did not alter long-term survival. In the absence of prospective, randomized, controlled trials, the benefit of screening and surveillance to decrease mortality from EAC cannot be confirmed.
BACKGROUND: The efficacy of screening and surveillance EGD for esophageal adenocarcinoma (EAC) is controversial. OBJECTIVE: To examine the effect of an EGD before the diagnosis of EAC on survival after the diagnosis of cancer among patients with gastroesophageal reflux (GER). DESIGN: A retrospective, controlled cohort study. SUBJECTS: The national administrative databases of the Veterans Affairs were accessed, and patients diagnosed with EAC, from 1995 through 2003, who had a prior diagnosis consistent with GER were identified. Electronic medical records were then abstracted. Cases were subjects who had an EGD performed between 1 and 5 years before the diagnosis of EAC; controls were those subjects without a prior EGD. RESULTS: A total of 155 subjects with EAC and GER were identified. Cases with a history of an EGD at least 1 year before a diagnosis of EAC (n = 25) were diagnosed at earlier stages than those without a prior EGD (P = .02) but did not experience a significant improvement in survival (adjusted hazard ratio 0.93 [95% CI, 0.58-1.50]). Cases who had been enrolled in surveillance programs that adhered to published guidelines trended toward improved survival, but long-term survival reverted toward the rate found without any surveillance. CONCLUSIONS: A prior EGD was associated with an improved stage at the diagnosis of EAC but did not alter long-term survival. In the absence of prospective, randomized, controlled trials, the benefit of screening and surveillance to decrease mortality from EAC cannot be confirmed.
Authors: Prateek Sharma; Kenneth McQuaid; John Dent; M Brian Fennerty; Richard Sampliner; Stuart Spechler; Alan Cameron; Douglas Corley; Gary Falk; John Goldblum; John Hunter; Janusz Jankowski; Lars Lundell; Brian Reid; Nicholas J Shaheen; Amnon Sonnenberg; Kenneth Wang; Wilfred Weinstein Journal: Gastroenterology Date: 2004-07 Impact factor: 22.682
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Authors: Giuseppe Portale; Jeffrey H Peters; Jeffrey A Hagen; Steven R Demeester; Tasha A K Gandamihardja; Chadin Tharavej; Chih-Cheng Hsieh; Tom R Demeester Journal: Arch Surg Date: 2005-06
Authors: David Armstrong; John K Marshall; Naoki Chiba; Robert Enns; Carlo A Fallone; Ronnie Fass; Roger Hollingworth; Richard H Hunt; Peter J Kahrilas; Serge Mayrand; Paul Moayyedi; William G Paterson; Dan Sadowski; Sander Jo Veldhuyzen van Zanten Journal: Can J Gastroenterol Date: 2005-01 Impact factor: 3.522
Authors: Prateek Sharma; David A Katzka; Neil Gupta; Jaffer Ajani; Navtej Buttar; Amitabh Chak; Douglas Corley; Hashem El-Serag; Gary W Falk; Rebecca Fitzgerald; John Goldblum; Frank Gress; David H Ilson; John M Inadomi; Ernest J Kuipers; John P Lynch; Frank McKeon; David Metz; Pankaj J Pasricha; Oliver Pech; Richard Peek; Jeffrey H Peters; Alessandro Repici; Stefan Seewald; Nicholas J Shaheen; Rhonda F Souza; Stuart J Spechler; Prashanth Vennalaganti; Kenneth Wang Journal: Gastroenterology Date: 2015-08-19 Impact factor: 22.682
Authors: Stuart J Spechler; Prateek Sharma; Rhonda F Souza; John M Inadomi; Nicholas J Shaheen Journal: Gastroenterology Date: 2011-03 Impact factor: 22.682
Authors: Michael C Otterstatter; James D Brierley; Prithwish De; Larry F Ellison; Maureen Macintyre; Loraine D Marrett; Robert Semenciw; Hannah K Weir Journal: Can J Gastroenterol Date: 2012-10 Impact factor: 3.522