Barrett Esophagus Interventions: Patient Preference

A small survey indicates greater patient willingness to undergo endoscopic ablation versus aspirin therapy to prevent esophageal adenocarcinoma.

Prevention of progression to esophageal adenocarcinoma (EAC) is the “end game” of intervention strategies for patients with Barrett esophagus (BE). Endoscopic ablative therapies have been shown to significantly reduce progression from high-grade dysplasia to EAC (NEJM JW Gastroenterol May 27 2009), and some data suggest a possible chemopreventive role for aspirin through reduction in prostaglandin E₂ levels.

Investigators surveyed 81 patients with nondysplastic BE on their willingness to undergo endoscopic ablation or aspirin therapy. The ablation scenario cited a 50% reduced lifetime risk for EAC and a 5% risk for esophageal stricture as a consequence of treatment. The aspirin scenario cited reduced lifetime risks of 50% for EAC and 30% for…

Reviewing Author

David A. Johnson, MD

Disclosures

Consultant/Advisory boardMedscape/WebMD; Pfizer; CRH Medical Corporation; Aries

EquityCRH Medical Corporation

Editorial boardsMedscape Gastroenterology

Leadership positions in professional societiesAmerican College of Gastroenterology Research Institute Board of Directors