Margreet van Putten1, Brian T Johnston2, Liam J Murray3, Anna T Gavin3,4, Damian T McManus5, Shivaram Bhat6, Richard C Turkington7, Helen G Coleman3. 1. Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Eindhoven, the Netherlands. 2. 2Department of Gastroenterology, Royal Victoria Hospital, Belfast Health and Social Care Trust, Belfast, Northern Ireland. 3. 3Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland. 4. 4Northern Ireland Cancer Registry, Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland. 5. 5Department of Pathology, Belfast City Hospital, Belfast Health and Social Care Trust, Belfast, Northern Ireland. 6. Department of Gastroenterology, Craigavon Area Hospital, Southern Health and Social Care Trust, Belfast, Northern Ireland. 7. 7Centre for Cancer Research and Cell Biology, Queen's University Belfast, Belfast, Northern Ireland.
Abstract
BACKGROUND: A systematic review suggests that 25% of oesophageal adenocarcinomas (OAC) are 'missed' at index endoscopy for Barrett's oesophagus (BO); however, this included few population-based studies and may be an overestimate. OBJECTIVE: The objective of this article is to quantify the 'missed' rates of high-grade dysplasia (HGD) and OAC at index BO endoscopy. METHODS: Patients from the Northern Ireland BO register diagnosed between 1993 and 2010 (n = 13,159) were linked to the Northern Ireland Cancer Registry to identify patients who developed OAC or HGD. Logistic regression analysis compared characteristics of 'missed' vs 'incident' HGD/OAC, defined as diagnoses within 3-12 months vs >1 year after incident BO, respectively. RESULTS: A total of 267 patients were diagnosed with HGD/OAC ≥3 months after BO diagnosis, of whom 34 (12.7%) were potentially 'missed'. The proportion of 'missed' HGD/OAC was 25% among BO patients with low-grade dysplasia (LGD) and 9% among non-dysplastic BO patients. Older age and BO-LGD carried a higher risk of 'missed' HGD/OAC. Non-dysplastic BO patients were more often diagnosed with a 'missed' OAC (rather than HGD; 89%), compared with BO-LGD patients (40%). CONCLUSIONS: Approximately one in 10 HGD/OAC cases are 'missed' at incident BO diagnosis, which is significant but lower than previous reports. However, 'missed' HGD/OAC cases represent only 0.26% of all BO patients.
BACKGROUND: A systematic review suggests that 25% of oesophageal adenocarcinomas (OAC) are 'missed' at index endoscopy for Barrett's oesophagus (BO); however, this included few population-based studies and may be an overestimate. OBJECTIVE: The objective of this article is to quantify the 'missed' rates of high-grade dysplasia (HGD) and OAC at index BO endoscopy. METHODS: Patients from the Northern Ireland BO register diagnosed between 1993 and 2010 (n = 13,159) were linked to the Northern Ireland Cancer Registry to identify patients who developed OAC or HGD. Logistic regression analysis compared characteristics of 'missed' vs 'incident' HGD/OAC, defined as diagnoses within 3-12 months vs >1 year after incident BO, respectively. RESULTS: A total of 267 patients were diagnosed with HGD/OAC ≥3 months after BO diagnosis, of whom 34 (12.7%) were potentially 'missed'. The proportion of 'missed' HGD/OAC was 25% among BO patients with low-grade dysplasia (LGD) and 9% among non-dysplastic BO patients. Older age and BO-LGD carried a higher risk of 'missed' HGD/OAC. Non-dysplastic BO patients were more often diagnosed with a 'missed' OAC (rather than HGD; 89%), compared with BO-LGD patients (40%). CONCLUSIONS: Approximately one in 10 HGD/OAC cases are 'missed' at incident BO diagnosis, which is significant but lower than previous reports. However, 'missed' HGD/OAC cases represent only 0.26% of all BO patients.
Authors: Kavel Visrodia; Siddharth Singh; Rajesh Krishnamoorthi; David A Ahlquist; Kenneth K Wang; Prasad G Iyer; David A Katzka Journal: Gastroenterology Date: 2015-11-24 Impact factor: 22.682
Authors: Brian Bressler; Lawrence F Paszat; Zhongliang Chen; Deanna M Rothwell; Chris Vinden; Linda Rabeneck Journal: Gastroenterology Date: 2007-01 Impact factor: 22.682
Authors: Rehan J Haidry; Gideon Lipman; Matthew R Banks; Mohammed A Butt; Vinay Sehgal; David Graham; Jason M Dunn; Abhinav Gupta; Rami Sweis; Haroon Miah; Danielle Morris; Howard L Smart; Pradeep Bhandari; Robert Willert; Grant Fullarton; Jonathon Morris; Massimo Di Pietro; Charles Gordon; Ian Penman; High Barr; Praful Patel; Philip Boger; Neil Kapoor; Brinder Mahon; Jonathon Hoare; Ravi Narayanasamy; Dermot O'Toole; Edward Cheong; Natalie C Direkze; Yeng Ang; Andrew Veitch; Anjan Dhar; David Nyalender; Krish Ragunath; Anthony Leahy; Mark Fullard; Manuel Rodriguez-Justo; Marco Novelli; Laurence B Lovat Journal: Endoscopy Date: 2015-06-30 Impact factor: 10.093
Authors: Frederik Hvid-Jensen; Lars Pedersen; Asbjørn Mohr Drewes; Henrik Toft Sørensen; Peter Funch-Jensen Journal: N Engl J Med Date: 2011-10-13 Impact factor: 91.245
Authors: L A Anderson; L J Murray; S J Murphy; D A Fitzpatrick; B T Johnston; R G P Watson; P McCarron; A T Gavin Journal: Gut Date: 2003-08 Impact factor: 23.059
Authors: Matthew D Stachler; Amaro Taylor-Weiner; Shouyong Peng; Aaron McKenna; Agoston T Agoston; Robert D Odze; Jon M Davison; Katie S Nason; Massimo Loda; Ignaty Leshchiner; Chip Stewart; Petar Stojanov; Sara Seepo; Michael S Lawrence; Daysha Ferrer-Torres; Jules Lin; Andrew C Chang; Stacey B Gabriel; Eric S Lander; David G Beer; Gad Getz; Scott L Carter; Adam J Bass Journal: Nat Genet Date: 2015-07-20 Impact factor: 38.330
Authors: Sabina Beg; Krish Ragunath; Andrew Wyman; Matthew Banks; Nigel Trudgill; D Mark Pritchard; Stuart Riley; John Anderson; Helen Griffiths; Pradeep Bhandari; Phillip Kaye; Andrew Veitch Journal: Gut Date: 2017-08-18 Impact factor: 23.059
Authors: Rebecca C Fitzgerald; Massimiliano di Pietro; Krish Ragunath; Yeng Ang; Jin-Yong Kang; Peter Watson; Nigel Trudgill; Praful Patel; Philip V Kaye; Scott Sanders; Maria O'Donovan; Elizabeth Bird-Lieberman; Pradeep Bhandari; Janusz A Jankowski; Stephen Attwood; Simon L Parsons; Duncan Loft; Jesper Lagergren; Paul Moayyedi; Georgios Lyratzopoulos; John de Caestecker Journal: Gut Date: 2013-10-28 Impact factor: 23.059
Authors: Theresa H Nguyen; Aaron P Thrift; Rollin George; Daniel G Rosen; Hashem B El-Serag; Gyanprakash A Ketwaroo Journal: Clin Gastroenterol Hepatol Date: 2021-04-08 Impact factor: 11.382
Authors: Lovekirat Dhaliwal; D Chamil Codipilly; Parth Gandhi; Michele L Johnson; Ramona Lansing; Kenneth K Wang; Cadman L Leggett; David A Katzka; Prasad G Iyer Journal: Clin Gastroenterol Hepatol Date: 2020-07-21 Impact factor: 11.382