ArticleArchives of surgery (Chicago, Ill. : 1960)2011
Gastroesophageal reflux disease symptom severity, proton pump inhibitor use, and esophageal carcinogenesis.
Article in Archives of surgery (Chicago, Ill. : 1960), 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
16 citing papers in PubMed, 53 citations in OpenAlex.
- Implementation of Provider-Facing Interventions to Increase Uptake of Endoscopic Screening for Esophageal Adenocarcinoma.Gastro hep advances · 2026Article
- Predicting Incident Adenocarcinoma of the Esophagus or Gastric Cardia Using Machine Learning of Electronic Health Records.Gastroenterology · 2023Article
- Quality of life and severity of symptoms among patients with various degrees of reflux esophagitis: a prospective study.Scientific reports · 2023Article
- Pepsin and Laryngeal and Hypopharyngeal Carcinomas.Clinical and experimental otorhinolaryngology · 2021Review
- Third-time ("redo-redo") anti-reflux surgery: patient-reported outcomes after a thoracoabdominal approach.Surgical endoscopy · 2020Article
- Development and validation of a risk prediction model to diagnose Barrett's oesophagus (MARK-BE): a case-control machine learning approach.The Lancet. Digital health · 2020Article
- Screening for Barrett's Esophagus: Balancing Clinical Value and Cost-effectiveness.Journal of neurogastroenterology and motility · 2019Article
- Laparoscopic Adjustable Gastric Banding: an Underestimated Risk Factor for the Development of Esophageal Cancer?-a Nationwide Survey.Obesity surgery · 2019Article
- Local Synthesis of Pepsin in Barrett's Esophagus and the Role of Pepsin in Esophageal Adenocarcinoma.The Annals of otology, rhinology, and laryngology · 2015Article
- Epidemiology, Diagnosis, and Management of Esophageal Adenocarcinoma.Gastroenterology · 2015Review
- Risk of upper gastrointestinal cancers in patients with gastroesophageal reflux disease after a negative screening endoscopy.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2015Article
- A cross-sectional analysis of the prevalence of Barrett esophagus in otolaryngology patients with laryngeal symptoms.Journal of clinical gastroenterology · 2013Article
- Upper gastrointestinal cancer and reflux disease.Journal of gastric cancer · 2013Article
- Age at onset of GERD symptoms predicts risk of Barrett's esophagus.The American journal of gastroenterology · 2013Article
- Nutrition therapy issues in esophageal cancer.Current gastroenterology reports · 2012Review
- Gastroesophageal Reflux Frequency, Severity, Age of Onset, Family History and Acid Suppressive Therapy Predict Barrett Esophagus in a Large Population.Journal of clinical gastroenterologyArticle
Corrections and comments
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
Abstract
hypothesisScreening for esophageal adenocarcinoma has focused on identifying Barrett esophagus (BE) in patients with severe, long-standing symptoms of gastroesophageal reflux disease (GERD). Unfortunately, 95% of patients who develop esophageal adenocarcinoma are unaware of the presence of BE before their cancer diagnosis, which means they never had been selected for screening. One possible explanation is that no correlation exists between the severity of GERD symptoms and cancer risk. We hypothesize that severe GERD symptoms are not associated with an increase in the prevalence of BE, dysplasia, or cancer in patients undergoing primary endoscopic screening.
designCross-sectional study.
settingUniversity hospital. PATIENTS: A total of 769 patients with GERD.
interventionsPrimary screening endoscopy performed from November 1, 2004, through June 7, 2007. MAIN OUTCOMES MEASURES: Symptom severity, proton pump inhibitor therapy, and esophageal adenocarcinogenesis (ie, BE, dysplasia, or cancer).
resultsEndoscopy revealed adenocarcinogenesis in 122 patients. An increasing number of severe GERD symptoms correlated positively with endoscopic findings of esophagitis (odds ratio, 1.05; 95% confidence interval, 1.01-1.09). Conversely, an increasing number of severe GERD symptoms were associated with decreased odds of adenocarcinogenesis (odds ratio, 0.94; 95% confidence interval, 0.89-0.98). Patients taking proton pump inhibitors were 61.3% and 81.5% more likely to have adenocarcinogenesis if they reported no severe typical or atypical GERD symptoms, respectively, compared with patients taking proton pump inhibitors, who reported that all symptoms were severe.
conclusionsMedically treated patients with mild or absent GERD symptoms have significantly higher odds of adenocarcinogenesis compared with medically treated patients with severe GERD symptoms. This finding may explain the failure of the current screening paradigm in which the threshold for primary endoscopic examination is based on symptom severity.
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