Risk of Malignancy with Barrett’s Esophagus

It is estimated that about 10 to 15 percent of individuals with severe symptoms of GERD will develop Barrett’s esophagus. This is a serious disorder that affects the lining of the esophagus, changing it from normal esophageal tissue into tissue that is similar to the intestinal lining. Reflux symptoms are often the only signs of Barrett’s Esophagus, which are typical of GERD such as frequent heartburn, acid reflux and belching. Although it was reported that individuals with this disorder were at greater risk of developing esophageal Adenocarcinoma, an often fatal type of cancer of the esophagus, according to a recent study, this risk may not be as high as what was previously believed.
Patients with Barrett’s esophagus were often advised to undergo regular endoscopies for early diagnosis of Adenocarcinoma in the event it should occur. However, based on the study that was reported in the Journal of the National Cancer Institute’s June 16 issue, this might not be necessary. Estimates on the number of cases of this disorder that actually turned into a malignancy have been unclear with conflicting reports showing that between 0.58 to 3 percent of those with Barrett’s esophagus do develop cancer each year.
A new study however, shows that the incidence of cancer occurring due to Barrett’s esophagus is significantly lower than what was previously reported. The study included 8,522 participants, all with Barrett’s Esophagus who were studied for 7 years. The results showed that 36 participants developed precancerous changes, 16 developed cancer of the gastric cardia and 79 were diagnosed with esophageal cancer. These conditions combined equaled 0.22 percent.
Most individuals who experienced a progression had previously been diagnosed with intestinal metaplasia, a condition that transforms the stomach’s cells into intestinal cells. Based on the reported decrease in incidents of esophageal cancer from Barrett’s esophagus, some Columbus doctors are now advising patients who have been diagnosed with intestinal metaplasia to continue with frequent surveillance. Those without this condition are now believed to be at a much lower risk for developing esophageal cancer and may not benefit from frequent endoscopies.