GASTROENTEROLOGY ARTICLE OF THE WEEK
February 25, 2010
Sharma P. Barrett’s Esophagus. N Engl J Med 2009;361:2548-56.
1. The annual risk of developing cancer in Barrett’s mucosa is estimated to be
a. 5%
b. 2%
c. 0.5%
d. 10%
2. Factors associated with an increased risk of Barrett’s include
a. Obesity
b. Smoking
c. H. pylori infection
d. Red wine consumption
e. heartburn
f. Male sex
True or False
3. Acid reduction, either by PPI or anti-reflux procedure does not decrease the risk of cancer in Barrett’s epithelium
4. The most common type of esophageal cancer diagnosed in the US currently is squamous cell carcinoma
5. Endoscopic eradication therapy is helpful in patients with non-dysplastic Barrett’s epithelium.
6. Use of NSAID’s increases risk of malignancy in Barrett’s epithelium
7. Low grade dysplasia should be followed with a repeat endoscopy in 6 months, if no advanced disease, then yearly
8. Surveillance endoscopies after establishing a diagnosis of Barretts have been showen to reduce mortality from esophageal cancer
9. The majority of patients with low grade dysplasia on screening endoscopy will be found to have high grade dysplasia on follow up endoscopy
10. The chances of having synchronous adenocarcinoma if high grade dysplasia is detected and no mucosal abnormalities noted is about 3%
11. Adenocarcinoma invading the submucosa is a strong relative contraindication to endoscopic therapy.