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04-01-2011 | Gastroenterology | Article

EAC screening beneficial only in older White men with GERD

Abstract

Free abstract

MedWire News: Screening for esophageal adenocarcinoma (EAC) might be warranted in White men aged over 60 years with weekly symptoms of gastroesophageal reflux disease (GERD), suggest study results showing a high incidence in this population.

The findings also show that screening for EAC would most likely be of little benefit in men aged younger than 50 years or in women, regardless of the frequency of GERD symptoms, because of the very low incidence of cancer.

"Since GERD is incredibly common, many people may be worried about their increased risk for developing cancer due to GERD. The results help put that risk into perspective and may help physicians decide when screening to prevent cancer is needed," said leady study author Joel Rubenstein (Veterans Affairs Medical Center, Michigan, USA).

The incidence of EAC in American White non-Hispanic patients with GERD was calculated with a Markov computer model using data from the US Surveillance Epidemiology and End Results cancer registry, a systematic review, and a meta-analysis of published studies.

The researchers found a very low incidence of EAC in men with GERD aged younger than 50 years compared with those aged over 60 years, at 1.0/100,000 at age 35 years versus 60.8/100,000 at age 70 years.

In comparison, the incidence of colorectal cancer at any age was at least three-fold greater than the expected incidence of EAC in men with weekly GERD. This relative risk was highest in younger age groups, with men aged 35 years having a 6.7-fold higher risk for colorectal cancer than EAC.

The study also revealed that the incidence of EAC in women with GERD of any age was extremely low (eg, 3.9/100,000 at age 60 years), and was similar to that of breast cancer in men.

Discussing the importance of the findings, Rubenstein said: "Our study does not say who should be screened or the effectiveness of the screening. But we can say that for a 60-year-old man with GERD, screening for colon cancer is more important than screening for EAC."

He concluded: "We hope this study can help physicians recognize the absolute risk of EAC in patients with GERD within the context of the risk of more familiar cancers, and make it easier to communicate these risks to patients, guiding them in rational decisions about screening procedures."

The findings are published in the American Journal of Gastroenterology.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Ingrid Grasmo

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