Patients with GERD had a low risk for developing upper gastrointestinal cancers after a negative screening endoscopy, which justifies current practice guidelines recommending a one-time screening endoscopy, according to research data.
“The very low incidence of subsequent cancers in this cohort of patients with GERD who underwent an initial endoscopy negative for Barrett's or cancer supports clinical practice guidelines recommending against repeating endoscopy for patients with GERD unless new symptoms arise,” Hashem B. El-Serag, MD, MPH, from Baylor College of Medicine and Michael E. DeBakey VA Medical Center in Houston, told Healio Gastroenterology.
Using data from 121 Veterans Health Administration centers, El-Serag and colleagues performed a retrospective cohort study of 68,610 patients with GERD (mean age, 55.5 years; 90% men; 67.5% white) who underwent one negative esophagogastroduodenoscopy (EGD) to determine incidence and risk factors associated with developing subsequent esophageal adenocarcinoma or other upper GI cancers. Patients received a GERD diagnosis between October 2003 and September 2009 and had a negative EGD within 1 year.
Hashem B. El-Serag
The mean follow-up period was 3.2 ± 2 years (219,178 patient-years) during which 29 patients developed upper GI cancer (10 esophageal adenocarcinoma; 19 other). Incidence rate for esophageal adenocarcinoma was 4.6 (95% CI, 2.2-8.3) per 100,000 person-years of follow-up and the incidence rate for all upper GI cancers was 13.2 (95% CI, 8.9-19) per 100,000 person-years. Patients who developed subsequent cancer were older than patients who did not (34.5% vs. 18.4% older than 65 years), and had higher modified Deyo scores (P < .0001).
“The incidence of subsequent cancers during a mean follow-up period of 3.2 years among patients with GERD and a negative screening EGD is low enough to justify not recommending repeating an EGD in these patients,” the researchers concluded. “This is in agreement with the guidelines published by major gastrointestinal societies.” – by Adam Leitenberger
Disclosure: The researchers report no relevant financial disclosures.