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Prevention of Cancer by Control of Reflux

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Barrett’s Esophagus

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Abstract

The average age of people presenting with esophageal adenocarcinoma is about 20 years older than that of patients with known or newly diagnosed Barrett’s esophagus1–3. The long duration between development of Barrett’s esophagus and its malignant degeneration is important to bear in mind since it suggests that there is a significant time interval during which therapeutic and/or preventive interventions may have the potential to be effective. The accessibility of the esophagus for inspection and biopsy and the observation that results of surgical treatment for esophageal adenocarcinoma are directly linked to the stage of the disease at the time of discovery, have led to the introduction of endoscopic surveillance for patients with Barrett’s esophagus4–8. This approach has been supported by the reports that patients with esophageal adenocarcinoma detected within a surveillance program present at an early stage and have significantly better survival than those who present de novo6–9. Investigators have also found that the majority of patients with Barrett’s adenocarcinoma do report a past history of chronic heartburn when specifically questioned. This point emphasizes the need to endoscope patients with chronic heartburn and take multiple biopsies from the distal esophagus even when the appearance may be relatively normal. In doing so, the physician can exclude or identify Barrett’s esophagus prior to placing patients on long term therapy or offer antireflux surgery.

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  1. Lars Lundell
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Editors and Affiliations

  1. Erasmus University Medical Centre, Rotterdam, The Netherlands

    Hugo W. Tilanus (Professor of Surgery) (Professor of Surgery)

  2. Hope Hospital, Salford, UK

    Stephen E. A. Attwood F.R.C.S. (Consultant Surgeon) (Consultant Surgeon)

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Lundell, L. (2001). Prevention of Cancer by Control of Reflux. In: Tilanus, H.W., Attwood, S.E.A. (eds) Barrett’s Esophagus. Springer, Dordrecht. https://doi.org/10.1007/978-94-017-0829-6_17

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  • DOI: https://doi.org/10.1007/978-94-017-0829-6_17

  • Publisher Name: Springer, Dordrecht

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