Elevated cancer risk perceptions among patients with Barrett's esophagus: do psychological factors play a role?

Barrett's esophagus is a chronic esophageal condition that is associated with an increased risk of esophageal adenocarcinoma. This chronic condition negatively impacts patients' quality of life and is associated with increased levels of psychological distress. In 'Perceptions of risk and therapy among patients with Barrett's esophagus: a patient survey study,' Stier et al. explored factors associated with esophageal cancer risk perception and management decisions among patients with Barrett's esophagus. The results indicate that patients greatly overestimate their cancer risk and are willing to accept low success rates and high risks of complications to undergo endoscopic therapy. These findings are important and contribute to our understanding of patient risk perceptions in this population. However, psychological factors were not considered in this study and are potentially important patient characteristics influencing risk perceptions. Anxiety in particular warrants more attention in this population. Furthermore, the study findings indicate that patients have a strong preference for communicating with their physician regarding disease information. Therefore, greater emphasis on patient-centered communication strategies during conversations about Barrett's esophagus and cancer risk may be helpful for reducing patients' psychological distress and engaging patients in shared decision making regarding management strategies.