After conducting a thorough literature review, researchers have determined that good endoscopic (tubes with cameras) equipment, more endoscopic surgery and more tissue sampling make up the best strategy for preventing esophageal diseases from progressing to cancer.
"Talk to your doctor if you have acid reflux."
A total of 92 researchers from around the world, led by Professor Janusz Jankowski of the Blizard Institute of Cell and Molecular Science at Queen Mary, University of London, analyzed almost 12,000 papers dealing with the management of Barrett's dysplasia (a pre-cancerous condition) and early stage esophageal cancer.
The scientists employed a new way of determining the quality of the evidence used in this research. Called the Delphi Method, all scientists used a voting/grading model to come to consensus
Barrett's esophagus is characterized by abnormal changes in the cells lining the lower esophagus. Between 10-20 percent of people with acid reflux go on to develop this condition.
Untreated Barrett's esophagus can progress to Barrett's dysplasia, which is a pre-cancerous condition that can lead to full-blown esophageal cancer, one of the most fatal malignancies.
After reviewing the literature, the scientists had four rounds of voting on various conclusions gathered from the research papers studied.
"The key messages to emerge from this process are that the endoscopic equipment needs to be good...and that endoscopic surgery can be better than the more risky open surgery," said Professor Jankowski, who is the Sir James Black Professor of Gastrointestinal Biology and Trials.
"In addition, there needs to be more and larger samples of tissues taken so that the pathologist can make sure that no early cancers are missed," Dr. Janowski said. "At present, there are no reliable biomarkers (molecular changes) that can replace good equipment, a well-trained endoscopist and a methodical pathologist."
Endoscopy involves the use a tiny tube, equipped with a camera and sometimes instruments that can remove lesions.
Barrett's esophagus affects about two percent of the population, according to the researchers. It's most commonly seen in men over the age of 50.
The risk of Barrett's esophagus progressing to cancer is estimated to be approximately 0.5-1 percent a year.
Every year, about 17,500 Americans are diagnosed with esophageal cancer, one of the cancers that's on the rise.
Dr. Janowki concluded: "We have used novel methods and a huge team to come up with simple ways to improve care in one of the commonest pre-cancerous conditions, which, if left unmonitored or untreated, can develop into a cancer that is usually fatal.
This research was published in the August issue of the medical journal Gastroenterology.
Funding information and financial disclosures were not available.