AURORA, Colo. — The most effective form of cancer care is prevention, which is why effectively screening for the disease is everything. For esophageal cancer, a team from the University of Colorado Cancer Center is working to improve the effectiveness of screening and surveillance for early detection of it. The faculty is specifically focusing on Barrett’s esophagus (BE), a common condition that often ends up leading to esophageal adenocarcinoma (EAC), a lethal form of cancer. Over the last several decades, the incidence and mortality rates of this disease have continued to rise.
The researchers analyzed a large international database of over 20,000 newly diagnosed BE patients in Denmark, Finland, and Sweden from 2006 to 2020 in order to get a closer look at how many patients have normal endoscopies but still end up receiving an EAC diagnosis shortly after.
“We found a high proportion of esophageal cancers were found in patients after receiving a normal endoscopy and before the next recommended endoscopy,” says first author Sachin Wani, MD, professor of medicine and director of the Katy O. and Paul M. Rady Esophageal and Gastric Center of Excellence at the CU Cancer Center, in a media release.
Their findings showed that 25 to 46 percent of EAC cases were categorized as post-endoscopy esophageal adenocarcinoma (PEEC), which describes esophageal cancer identified within one year of a non-diagnostic upper endoscopy. In other words, current screening tools aren’t effective for around a quarter of patients.
“These missed cancers can impact survival rates since catching cancer early is critical for effective treatment,” says Dr. Wani.
At the same time, Wani points out that the missed cancers could also offer insight that can help improve intervention efforts.
“In the past, research was mostly focused on observational studies that were plagued by small sample sizes or selection bias. This means we didn’t have a true picture of how current screening practices aren’t working for nearly a quarter of EAC patients. With this new research, we’re providing more data which is an opportunity to improve the effectiveness of screening and surveillance practices,” the doctor adds.
It remains unclear as to why current screening tools aren’t able to pick up these cancers, but the researchers have some suggestions in order to improve them.
“We suggest providers use the highest quality endoscopy equipment, spend adequate time inspecting the Barrett’s segment and ensure that they have the most rigorous sampling protocols in place,” explains Wani. “At the end of the day, we hope this data can influence providers in clinical practice to improve the quality of care and endoscopies for BE.”
The findings are published in the journal Gastroenterology.
