Beaumont Study Finds Esophageal Cancer Risk May Be Lower For Some

ROYAL OAK -- A research study published by a Beaumont Hospital physician is helping to clarify the risk of esophageal cancer associated with reflux disease and may lessen the frequency of surveillance required for some with the condition.

The research, led by Tusar Desai, M.D., was published in a recent issue of "GUT: An International Journal of Gastroenterology and Hepatology." Dr. Desai specializes in gastroenterology and hepatology at Beaumont Hospital, Royal Oak and is an assistant professor at the Oakland University William Beaumont School of Medicine.

The meta-analysis study combined data from 57 studies involving 11,434 patients conducted from 1966 to 2011. It involved a review of previously published and unpublished research to look at the incidence of esophageal cancer in patients with Barrett's esophagus.

Barrett's esophagus, which affects approximately 10 percent of patients with chronic reflux, is a condition in which normal cells that line the esophagus, called squamous cells, turn into a different cell type, intestinal metaplasia. Damage to the lining of the esophagus from chronic gastroesophageal reflux disease, commonly called GERD or acid reflux, causes the cells to change.

Dysplasia is the microscopic change in those intestinal cells lining the esophagus and indicates an increasing risk of cancer development.

"We found that the frequency of esophageal cancer in people with Barrett's esophagus showing no dysplasia is about one in 300 patients per year and may even be lower in some," says Dr. Desai. Previous studies conducted in 2000 estimated the incidence of esophageal cancer in Barrett's esophagus patients at 1 in 200 patients per year.  Patients with documented Barrett's change require endoscopy at a regular interval to observe for advancing dysplasia; the need for these procedures may be reduced, benefiting both patients and the health care system."

Added Robert Jury, M.D., system lead of the Digestive Health Center of Excellence at Beaumont Heath System: "This demonstrates the importance of careful, comprehensive evaluation by physicians who specialize in reflux disease, such as those at Beaumont's Center for Reflux and Esophageal Cancer Prevention, to accurately determine a patient's risk of developing cancer as well as appropriate monitoring and treatment. Information such as this is important in the development of evidence-based best practice guidelines to standardize patient care and improve patient safety.

In addition to monitoring patients for progression of Barrett's esophagus toward cancer, some patients benefit from a minimally invasive radiofrequency treatment called BARRX. In that procedure, performed by endoscopy, the abnormal lining of the esophagus is destroyed with thermal energy allowing regrowth of normal lining cells.

Beaumont's Centers for Reflux and Esophageal Cancer Prevention, located in Royal Oak and Troy, offer the state's only multidisciplinary team of reflux and Barrett's specialists, including gastroenterologists, otolaryngologists, pathologists, thoracic and gastrointestinal surgeons, nurses and clinical navigators to assist with scheduling appointments.   The centers provide patient education, screening, evaluation and the latest treatments for digestive health conditions, including minimally invasive surgical procedures. Beaumont digestive health specialists work with patients to develop individual treatment strategies to resolve symptoms and prevent esophageal cancer.

For information or to schedule an appointment at the centers, call 888-99-REFLUX (888-997-3358).

Barrett's esophagus affects more than three million people over the age of 50 in the U.S. and is often associated with chronic reflux disease. People who have had long-standing heartburn are at risk for Barrett's esophagus. Most common symptoms of the disease include waking in the night from heartburn pain; vomiting; difficulty in swallowing; and blood in vomit or stool.

Esophageal cancer is diagnosed in about 16,500 Americans each year and accounts for about 14,500 U.S. cancer deaths annually. It is the cancer with the fastest rising incidence rate (400 percent since the 1970s) and a 5-year survival rate of less than 15 percent.