Kudos to The Jewish Link and Dr. Alfred I. Neugut for sharing this important information (“Barrett’s Esophagus,” December 12, 2024). We believe that increasing awareness that persistent reflux disease can cause cancer does save lives.
Even when it’s caught early, the EAC (Esophageal Adenocarcinoma) survival rate is less than 50%. But because Barrett’s Esophagus is silent, most patients are diagnosed with EAC at later stages when treatment is rarely effective, though new therapies are improving these numbers a bit. But it is still true that only one out of five EAC patients will survive five years after diagnosis.
Although many people believe that people over 50 are the only ones who need to be concerned about this, we have seen a doubling of this devastating diagnosis among young people in recent years. It is heartbreaking to see these young people robbed of a future. Some have been diagnosed as young as 16 years of age!
As to the issue of screening, we were pleased to see the Best4 trial launched in the U.K. to answer the question of whether everyone should be screened for EAC. A minimally invasive test that doesn’t require sedation and takes about 10 minutes to complete will be the tool used to screen more than 100,000 Brits. But we won’t know the outcome for several years.
Today, another minimally invasive test called EsoGuard that similarly does not require sedation is available in the United States. We are hopeful that insurance coverage for this DNA test will be approved soon so more patients can have access to this potentially life-saving screening.
Another recent advancement now allows for testing folks with Barrett’s Esophagus to determine their risk of progressing from BE to EAC. TissueCypher is proving to be a useful tool that can either prompt treatment for those at higher risk or reduce the frequency of surveillance for those at low risk.
As Dr. Neugut highlights, current guidelines for performing upper endoscopy leave out many patients at risk—including women and younger people.
We hope to see the day when everyone with even one persistent risk factor can be easily and affordably screened.
