GASTROENTEROLOGY ARTICLE OF THE WEEK
May 26, 2011
AGA. American Gastroenterological Association Medical Position Statement on the Management of Barrett’s Esophagus. Gastroenterology 2011;140:1084-1091.
1. The annual incidence of esophageal cancer for a population of patients with Barrett’s esophagus is:
a. 1%
b. 0.05%
c. 3%
d. 0.5%
2. Risk per year of progressing to cancer from confirmed high grade dysplasia is
a. 80%
b. 70%
c.6%
d. 20%
3. Endoscopic therapy for Barrett’s esophagus (RFA or PDT) is reasonable in which of the following scenarios
a. esophageal adenocarcinoma, 3 cm length
b. Barretts flat mucosa with confirmed HGD
c. Barretts epithelium, Prague C5 M7, BMI 27, non-smoker, no dysplasia
d. Barretts Prague C3 M4, no raised lesions, LGD on 2 EGDs 6 months apart
e. Barrett’s Prague C8 M10, male, age 55, no raised lesions, no dysplasia, BMI 38, smoker, large hiatal hernia
True or False
4. Patients with known dysplasia should undergo 4 quadrant biopsies every centimeter
5. There is no relationship between the length of the metaplastic epithelium and the cancer risk.
6. Approximately 40% of patients with esophageal adenocarcinoma report no history of heartburn.
7. Chromoendoscopy should be used in most cases with proven HGD
8. Patients with Barrett’s esophagus and high grade dysplasia should receive bid PPI for maximal acid suppression and to minimize risk of progression to adenocarcinoma.
9. RFA therapy for patients with Barrett’s and HGD reduces risk of progression to cancer