NEW YORK (Reuters Health) - Although people with chronic acid reflux are more likely to develop the throat or esophageal cancer, a new study suggests the risk is too low to justify the systematic screening for cancer.
Researchers that the conclusions should reassure people with heartburn that their chances of developing esophageal cancer are minimal.
"For young men and women, the absolute risk of esophageal cancer is very low, and probably not something they need to worry, said researcher Dr. Joel h. Rubenstein, senior faculty of medicine at the University of Michigan in Ann Arbor.".
And even for patients at risk relatively workplan - men aged over 60 with weekly heartburn heartburn and other symptoms - it is still too little evidence to recommend the systematic screening for cancer.
Gastroesophageal reflux disease or GERD, is considered a first risk factor for cancer of the esophagus. Disorder, whose main symptom is frequent heartburn, allows the stomach acids back up into the esophagus, where it can damage the wall and a small number of cases, lead to cancerous changes.
Because of this, doctors often recommend that people with long, frequent heartburn undergo pre-cancerous changes with a range of camera-equipped enfiling esophagus, a so-called upper endoscopy.
There is, however, some guidelines advise specifically such screening.
The central problem is that while the experience of approximately 60 million Americans heartburn at least once per month and 15 million daily symptoms, only 16,600 Americans were supposed to be diagnosed with esophageal cancer this year.
Therefore even if gastroesophageal reflux sufferers are relatively more to others, the chances of a person with frequent heartburn developing esophageal cancer still risk is likely very low.
The new study, published in the American journal of Gastroenterology, showed that.
Government cancer registry information using U.S. and other public data, Rubenstein team believes that for women of any age with the gastroesophageal reflux disease, the risk of cancer of the esophagus is "extremely low". Women's 60 years with weekly heartburn, for example, it would be four cases of cancer per 100,000 women per year.
In General, risk a woman of esophageal cancer has was on a par with cancer risk human.
Men aged under 50 with gastro-esophageal reflux has also had a very low risk of esophageal cancer: among the 35 years, for example, the rate was one of the 100 000. But increased older men. Men 70 years with weekly heartburn, the annual rate of esophageal cancer would be 61 per 100,000 inhabitants.
It is still only one-third of the rate of cancer of the colon in the group age, but high enough that researchers said could justify screening. However, there is no evidence of research solids that cervical cancer esophageal border deaths from the disease.
"It's very controversial if the screening is effective," said Rubenstein. "We have evidence of good quality that it works."
The scarcity of esophageal, even among people with gastroesophageal reflux disease, cancer is obstacle key clinical trials to verify whether the screening reduces mortality from cancer, Rubenstein said. A trial would include the large number of patients showing a statistically significant effect.
Then why not undergo cancer esophageal testing just to be safe? Because like all screening tests, it carries risks, said Rubenstein.
For example, a false positive result would create anxiety useless and unnecessary testing monitoring. And endoscopic screening itself can have complications such as perforation esophageal or reactions to medications used during the intervention.
These risks are small, Rubenstein noted. But the risk of cancer is so low in young men and women, he said, that risk screening likely outweigh the potential benefits.
For older men with heartburn frequently, Rubenstein said that screening could be a reasonable option, but it is something that they would have to discuss with their doctor. "It is a personal decision," he said.
"The strength of this study, it is that clinicians sitting with a patient can now provide a best estimate of their individual risk of esophageal cancer, said Mr. Richard Sampliner, a gastroenterologist at the University of Arizona at Tucson."
Sampliner pointed out, however, that individuals vary in their anxiety about cancer - if, for example, they have known someone who died of the disease, and certain people with gastroesophageal reflux will push to "scope."
He also noted that while the esophageal cancer is rare, it is often fatal, especially when diagnosed at later stages.
Persons diagnosed when cancer has spread to the lymph nodes, 19% are alive five years later. This figure is 37% when cancer is still confined to the site original and only three per cent if it has spread to locations in the body at the time of diagnosis.
Rubenstein noted that anyone with which develops potential symptoms of cancer of the esophagus, such as loss of involuntary weight, vomiting and difficulty in swallowing, gastroesophageal reflux should not hesitate to consult their physician.
SOURCE: http://link.reuters.com/qux32r American Journal of Gastroenterology, line 7 December 2010.
No comments:
Post a Comment