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01-01-2015 | Esophageal cancer | Book chapter | Article

8. The Role of Endoscopy in the Diagnosis, Staging, and Management of Esophageal Cancer

Authors: MD Michelle P. Clermont, MD Anthony M. Gamboa, MD, MPH Field F. Willingham

Publisher: Springer International Publishing

Abstract

The incidence of esophageal adenocarcinoma (EAC) has increased approximately 700 % since the late 1970s, outpacing the rate of growth of other major epithelial malignancies. Meanwhile the incidence of esophageal squamous cell carcinoma (ESCC) has declined over several decades. While SCC has no known premalignant condition amenable to screening or treatment, EAC is preceded by Barrett’s esophagus (BE), or intestinal metaplasia, in a metaplasia-dysplasia-carcinoma sequence. Therefore, BE has been a target for screening efforts and eradication via endoscopic approaches in order to detect and prevent EAC. The risk of developing EAC among patients with untreated BE is thought to be 0.4–0.5 % per year. Men and patients with long-segment BE have a higher risk of progression. The relatively good 5-year prognosis in early-stage disease compared with advanced stages has led to efforts aimed at the early detection of esophageal cancer in BE. The use of endoscopy for the prevention, diagnosis, and treatment of esophageal cancer continues to evolve.

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