Precision Prevention of Oesophageal Adenocarcinoma

Nat Rev Gastroenterol Hepatol. 2015 Apr;12(4):243-8. doi: 10.1038/nrgastro.2015.24. Epub 2015 Feb 10.

Abstract

The incidence of oesophageal adenocarcinoma has risen rapidly over the past four decades. Unfortunately, treatments have not kept pace; unless their cancer is identified at a very early stage, most patients will not survive a year after diagnosis. The beginnings of this widespread problem were first recognized over 25 years ago, yet rates have continued to rise against a backdrop of much improved understanding and management of oesophageal adenocarcinoma. We estimate that only ∼7% of the 10,000 cases of oesophageal adenocarcinoma diagnosed annually in the USA are identified through current approaches to cancer control, and trace pathways by which the remaining 93% are 'lost'. On the basis of emerging data on aetiology and predictive factors, together with new diagnostic tools, we suggest a five-tier strategy for prevention and control that begins with a wide population base and triages individuals into progressively higher risk strata, each with risk-appropriate prevention, screening and treatment options.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Adenocarcinoma / epidemiology
  • Adenocarcinoma / prevention & control*
  • Barrett Esophagus / diagnosis
  • Barrett Esophagus / epidemiology
  • Esophageal Neoplasms / epidemiology
  • Esophageal Neoplasms / prevention & control*
  • Gastroesophageal Reflux / diagnosis
  • Gastroesophageal Reflux / epidemiology
  • Humans
  • Incidence
  • Risk Factors

Supplementary concepts

  • Adenocarcinoma Of Esophagus