Gastroesophageal Reflux Disease Is Not a Great Screening Criterion: Time to Move on to Other Strategies for Controlling the Burden of Esophageal Adenocarcinoma

Am J Gastroenterol. 2022 Nov 1;117(11):1759-1761. doi: 10.14309/ajg.0000000000001998. Epub 2022 Sep 26.

Abstract

Gastroesophageal reflux disease (GERD) is key in the pathogenesis of Barrett's esophagus and esophageal adenocarcinoma (EAC). Endoscopic screening of select individuals with GERD symptoms for Barrett's esophagus and EAC has been recommended, but the great majority of patients with EAC had never undergone prior screening, despite over a million esophagogastroduodenoscopies (EGDs) performed annually in the United States among individuals with GERD symptoms. This is likely due to a conflation among providers regarding diagnostic EGD in those with refractory symptoms and screening EGD. An alternative approach is needed that de-emphasizes GERD to avoid confusion and increase uptake of appropriate screening.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adenocarcinoma* / diagnosis
  • Adenocarcinoma* / etiology
  • Adenocarcinoma* / pathology
  • Barrett Esophagus* / complications
  • Barrett Esophagus* / diagnosis
  • Esophageal Neoplasms* / diagnosis
  • Esophageal Neoplasms* / etiology
  • Esophageal Neoplasms* / prevention & control
  • Gastroesophageal Reflux* / complications
  • Gastroesophageal Reflux* / diagnosis
  • Humans

Supplementary concepts

  • Adenocarcinoma Of Esophagus