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'Missed' oesophageal adenocarcinoma and high-grade dysplasia in Barrett's oesophagus patients: A large population-based study.


ABSTRACT:

Background

A systematic review suggests that 25% of oesophageal adenocarcinomas (OAC) are 'missed' at index endoscopy for Barrett's oesophagus (BO); however, this included few population-based studies and may be an overestimate.

Objective

The objective of this article is to quantify the 'missed' rates of high-grade dysplasia (HGD) and OAC at index BO endoscopy.

Methods

Patients from the Northern Ireland BO register diagnosed between 1993 and 2010 (n?=?13,159) were linked to the Northern Ireland Cancer Registry to identify patients who developed OAC or HGD. Logistic regression analysis compared characteristics of 'missed' vs 'incident' HGD/OAC, defined as diagnoses within 3-12 months vs >1 year after incident BO, respectively.

Results

A total of 267 patients were diagnosed with HGD/OAC ?3 months after BO diagnosis, of whom 34 (12.7%) were potentially 'missed'. The proportion of 'missed' HGD/OAC was 25% among BO patients with low-grade dysplasia (LGD) and 9% among non-dysplastic BO patients. Older age and BO-LGD carried a higher risk of 'missed' HGD/OAC. Non-dysplastic BO patients were more often diagnosed with a 'missed' OAC (rather than HGD; 89%), compared with BO-LGD patients (40%).

Conclusions

Approximately one in 10 HGD/OAC cases are 'missed' at incident BO diagnosis, which is significant but lower than previous reports. However, 'missed' HGD/OAC cases represent only 0.26% of all BO patients.

SUBMITTER: van Putten M 

PROVIDER: S-EPMC5987274 | biostudies-literature | 2018 May

REPOSITORIES: biostudies-literature

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Publications

'Missed' oesophageal adenocarcinoma and high-grade dysplasia in Barrett's oesophagus patients: A large population-based study.

van Putten Margreet M   Johnston Brian T BT   Murray Liam J LJ   Gavin Anna T AT   McManus Damian T DT   Bhat Shivaram S   Turkington Richard C RC   Coleman Helen G HG  

United European gastroenterology journal 20171011 4


<h4>Background</h4>A systematic review suggests that 25% of oesophageal adenocarcinomas (OAC) are 'missed' at index endoscopy for Barrett's oesophagus (BO); however, this included few population-based studies and may be an overestimate.<h4>Objective</h4>The objective of this article is to quantify the 'missed' rates of high-grade dysplasia (HGD) and OAC at index BO endoscopy.<h4>Methods</h4>Patients from the Northern Ireland BO register diagnosed between 1993 and 2010 (<i>n</i> = 13,159) were li  ...[more]

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