GASTROENTEROLOGY ARTICLE OF THE WEEK
April 2, 2009
Shaheen NJ, Richter JE. Barrett’s oesophagus. Lancet 2009;373:850-61
1. The per-patient –year risk of adenocarcinoma in patients with Barrett’s esophagus is
a. 3%
b. 5%
c. 1%
d 0.5%
2. Factors significantly associated with the development of adenocarcinoma in Barrett’s include
a. BMI
b. Black race
c. Older age
d. Alcohol abuse
e. Smoking
3. Interventions that decrease cancer risk in Barrett’s esophagus include
a. yearly surveillance with endoscopy
b. high dose acid suppression
c. anti-reflux surgery
d. chronic therapy with celecoxib
True or False
4. Patients with Barrett’s esophagus have a life expectancy similar to age-matched controls
5. Intestinal metaplasia of the cardia without endoscopic evidence of Barrett’s esophagus is felt to be a more benign finding with a lower risk of adenocarcinoma compared to typical Barrett’s
6. Only Barrett’s esophagus with metaplastic segments of 3cm or longer are clinically significant
7. Patients undergoing EGD for GERD should routinely be biopsied in the cardia region, even if endoscopically normal, to detect intestinal metaplasia
8. Severe erosive esophagitis can mask the presence of Barrett’s during endoscopy
9. Patients with high grade dysplasia on Barrett’s epithelium have a per-patient-year risk of adenocarcinoma of 60%
10. H. pylori is felt to play a role in increasing the risk for adenocarcinoma of the esophagus
11. Finding high grade dysplasia in Barrett’s is associated with a high risk of adenocarcinoma and should be managed with esophagectomy in most patients.