Curbside Consultation in GERD: 49 Clinical Questions

Philip O. Katz, MD

Question 25: A 42-Year-Old Man Who Does Not Use Tobacco Or Alcohol But Has Chronic Reflux Presents For Evaluation And Wants To Know If He Is At Risk For Esophageal Cancer. What Do I Tell Him? Does His Risk Change If His Symptoms Are Effectively Relieved With Ppi Therapy? (continued)

Esophageal adenocarcinoma has increased substantially over the past several decades and is now the fastest rising cancer among white males in the United States. Although the risk factors of long duration, higher frequency, and perhaps increased severity of nocturnal reflux symptoms are associated with an increased risk of developing adeno-carcinoma (Figures 25-1 and 25-2), the prevailing clinical opinion is that patients with chronic gastroesophageal reflux disease are not at risk for the development of esophageal adenocarcinoma unless they have underlying intestinal metaplasia…