Barrett’s Esophagus Is Less Likely to Proceed to Cancer . . .

. . . than previously thought.  Barrett’s esophagus is the term used for changes in the cells lining the lower end of the gullet, or esophagus, which may proceed to cancer of the esophagus in some cases.  The uncertainty regarding the likelihood of this progression has led to possibly unnecessary surgeries.  To try to clarify the situation, University of Belfast researchers have analyzed data from a cancer registry in Northern Ireland, and reported their findings in the Journal of the National Cancer Institute.

There were 8,522 patients with Barrett’s esophagus in the registry.  After an average of 7 years, 79 of them were diagnosed with esophageal cancer, 16 with cancer of the upper part of the stomach (the cardia), and 36 with precancerous changes known as high-grade dysplasia of the cells at the lower end of the esophagus.  In the entire group, the incidence of these conditions combined was 0.22% per year.  Men rather than women and people aged 60 to 65 had higher risks of progressing to malignancy than others.

This analysis is very useful, as previous estimates of the likelihood of Barrett’s esophagus progressing to cancer have ranged from 0.6% to 3% per year.  It suggests that some of the current recommendations regarding surveillance can be safely cut back – for instance, endoscopies can be done less frequently.