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Esophageal Cancer Risk Less Dire for Certain Patients: Study
Date:10/12/2011

pinpoint a subset of patients that may benefit from surveillance."

The study is published Oct. 13 in the New England Journal of Medicine.

Using records from the Danish Pathology Registry and the Danish Cancer Registry from 1992 through 2009, Funch-Jensen and his team identified about 11,000 patients with Barrett's esophagus and analyzed their data for an average of five years. While those with the condition were found to have a much higher chance of developing esophageal cancer compared to the general population, only 0.12 percent go on to develop it each year -- much lower than the assumed risk of 0.5 percent, according to the study.

The 197 cases of esophageal cancer diagnosed among all patients known to have Barrett's esophagus represented only 7.6 percent of all such cases. During the same period, 2,602 new cases of esophageal cancer were diagnosed in the general population.

U.S. experts said the results of the study weren't surprising, though they probably wouldn't affect the standard of care established for Americans with Barrett's esophagus, who tend to undergo frequent endoscopies.

"I don't think based on this one study alone, we can actually make policy changes and certain societal recommendations about screening," said Dr. Anthony Starpoli, a gastroenterologist at Lenox Hill Hospital in New York City. "For me, what this does is let me tell the patient, 'I think you have a little less to worry about.' I think we can reassure our patients to allay the fear."

Dr. David Bernstein, chief of gastroenterology at North Shore University Hospital in Manhasset, N.Y., praised the study as "important and interesting" but emphasized that the cancer risk is still significant in those with Barrett's esophagus.

"We really don't have good guidelines in this country for screening patients with Barrett's for cancer, unless we find dysplasia," he said. "Whenever we mine a database, we're looking at numbers, not patient cha
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