Screening for oesophageal adenocarcinoma : an evaluation of a surveillance program for columnar metaplasia of the oesophagus
Nilsson, J LU ; Skobe, V ; Willén, R ; Johnsson, F LU and Johansson, Jan LU
(2000)
In Scandinavian Journal of Gastroenterology
35(1).
p.6-10
- Abstract
BACKGROUND: Screening patients with columnar metaplasia of the oesophagus for adenocarcinoma is controversial owing to the low cancer incidence and diverging opinions as to whether screening improves the prognosis of these patients. Our aim was to evaluate a screening program for adenocarcinoma in patients with columnar metaplasia in the oesophagus, with focus on cancer incidence and costs.
METHODS: One hundred and ninety-nine patients with columnar metaplasia of the oesophagus were identified through an endoscopy database, and the original patient records were reviewed.
RESULTS: The patients were followed up for 797 years in total and during this time were subjected to 1071 upper gastrointestinal endoscopies. During the... (More)
BACKGROUND: Screening patients with columnar metaplasia of the oesophagus for adenocarcinoma is controversial owing to the low cancer incidence and diverging opinions as to whether screening improves the prognosis of these patients. Our aim was to evaluate a screening program for adenocarcinoma in patients with columnar metaplasia in the oesophagus, with focus on cancer incidence and costs.
METHODS: One hundred and ninety-nine patients with columnar metaplasia of the oesophagus were identified through an endoscopy database, and the original patient records were reviewed.
RESULTS: The patients were followed up for 797 years in total and during this time were subjected to 1071 upper gastrointestinal endoscopies. During the screening period 5 patients presented with adenocarcinoma; thus the cancer-incidence was 1 in 159 patient-years. The cost of detecting one cancer was 294,950 SEK (US$ 37,815). However, only four of the five patients were suitable for oesophagectomy, and of these, one patient turned out to have an advanced cancer. All patients developing cancer had columnar metaplasia of the oesophagus longer than 3 cm and specialized columnar epithelium (intestinal metaplasia/Barrett oesophagus).
CONCLUSIONS: Low cancer incidence, high costs, and the doubtful prognosis for the patients with identified cancer question the benefits and cost-effectiveness of cancer screening among patients with columnar metaplasia in the oesophagus.
(Less)
- author
- Nilsson, J
LU
; Skobe, V
; Willén, R
; Johnsson, F
LU
and Johansson, Jan
LU
- organization
- publishing date
- 2000-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Adenocarcinoma/diagnosis, Adolescent, Adult, Aged, Aged, 80 and over, Cost-Benefit Analysis, Endoscopy, Gastrointestinal/economics, Esophageal Neoplasms/diagnosis, Esophagus/pathology, Female, Humans, Male, Metaplasia, Middle Aged, Prognosis
- in
- Scandinavian Journal of Gastroenterology
- volume
- 35
- issue
- 1
- pages
- 7 pages
- publisher
- Taylor & Francis
- external identifiers
-
- pmid:10672828
- scopus:0033971581
- ISSN
- 0036-5521
- DOI
- 10.1080/003655200750024461
- language
- English
- LU publication?
- yes
- id
- 17c4f2d1-d788-4b5e-bd8a-b15372da7499
- date added to LUP
- 2019-05-26 19:07:15
- date last changed
- 2024-10-02 02:07:31
@article{17c4f2d1-d788-4b5e-bd8a-b15372da7499,
abstract = {{<p>BACKGROUND: Screening patients with columnar metaplasia of the oesophagus for adenocarcinoma is controversial owing to the low cancer incidence and diverging opinions as to whether screening improves the prognosis of these patients. Our aim was to evaluate a screening program for adenocarcinoma in patients with columnar metaplasia in the oesophagus, with focus on cancer incidence and costs.</p><p>METHODS: One hundred and ninety-nine patients with columnar metaplasia of the oesophagus were identified through an endoscopy database, and the original patient records were reviewed.</p><p>RESULTS: The patients were followed up for 797 years in total and during this time were subjected to 1071 upper gastrointestinal endoscopies. During the screening period 5 patients presented with adenocarcinoma; thus the cancer-incidence was 1 in 159 patient-years. The cost of detecting one cancer was 294,950 SEK (US$ 37,815). However, only four of the five patients were suitable for oesophagectomy, and of these, one patient turned out to have an advanced cancer. All patients developing cancer had columnar metaplasia of the oesophagus longer than 3 cm and specialized columnar epithelium (intestinal metaplasia/Barrett oesophagus).</p><p>CONCLUSIONS: Low cancer incidence, high costs, and the doubtful prognosis for the patients with identified cancer question the benefits and cost-effectiveness of cancer screening among patients with columnar metaplasia in the oesophagus.</p>}},
author = {{Nilsson, J and Skobe, V and Willén, R and Johnsson, F and Johansson, Jan}},
issn = {{0036-5521}},
keywords = {{Adenocarcinoma/diagnosis; Adolescent; Adult; Aged; Aged, 80 and over; Cost-Benefit Analysis; Endoscopy, Gastrointestinal/economics; Esophageal Neoplasms/diagnosis; Esophagus/pathology; Female; Humans; Male; Metaplasia; Middle Aged; Prognosis}},
language = {{eng}},
number = {{1}},
pages = {{6--10}},
publisher = {{Taylor & Francis}},
series = {{Scandinavian Journal of Gastroenterology}},
title = {{Screening for oesophageal adenocarcinoma : an evaluation of a surveillance program for columnar metaplasia of the oesophagus}},
url = {{http://dx.doi.org/10.1080/003655200750024461}},
doi = {{10.1080/003655200750024461}},
volume = {{35}},
year = {{2000}},
}