Journal
CURRENT OPINION IN GASTROENTEROLOGY
Volume 30, Issue 5, Pages 477-483Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MOG.0000000000000090
Keywords
Barrett's esophagus; colon adenomas; gastric metaplasia; gastrointestinal surveillance
Categories
Funding
- National Cancer Institute [R21CA 167220, R01 CA134620, U54 CA 096297]
- National Institute of Minorities and Health Disparities [U54 MD 007587]
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Purpose of review Provide an evidence-based resource for the surveillance of gastrointestinal premalignant lesions, focusing on the scientific articles reported recently. Recent findings No randomized controlled clinical trials exist to definitively support the efficacy of surveillance programs for Barrett's esophagus and gastric intestinal metaplasia. However, surveillance of these premalignant lesions is recommended by some of the leading organizations. To optimize the usefulness of surveillance programs, targeting high-risk patients might maximize its benefits. A Barrett's esophagus segment of at least 3cm and evidence of intestinal metaplasia can help stratify those patients at highest risk for progression to esophageal adenocarcinoma. The location, extent, and severity of intestinal metaplasia are indicators of risk of developing gastric cancer. Patients with extensive intestinal metaplasia should be offered endoscopic surveillance. Quality in the baseline colonoscopy is crucial to decrease the risk of interval colorectal cancers. The importance of serrated polyps, as well as their surveillance intervals, is emphasized. Summary To optimize the usefulness of surveillance programs, targeting high-risk patients might maximize its benefits. Future research is needed to design more effective surveillance strategies. Recently, emerging imaging techniques hold promise for improving sensitivity of endoscopic surveillance of premalignant conditions in the gastrointestinal tract.
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