Patients with Barrett's esophagus - a disorder of the cells of the lower end of the esophagus- tend to get over-diagnosed with another condition that could indicate they are in a higher risk group for esophageal cancer. Low-grade dysplasia (LGD) is believed to be common in Barrett's patients but research published this week in The American Journal of Gastroenterology calls for more careful approaches to its diagnosis in order to improve targeting of those patients at risk of cancer.

It is believed that LGD - an abnormal development of cells - is quite common in Barrett's esophagus patients but that it does not indicate much of an increase in cancer risk. However, patients with Barrett's Esophagus are at greater risk for esophageal cancer, the fastest rising type of cancer in Western countries. Current recommendations for these patients include endoscopic screening to look for cellular changes such as LGD in their throat tissue, which could indicate cancer tumor development.

Jacques Bergman and colleagues show that not only is LGD over-diagnosed in Barrett's Esophagus patients but those that do have genuine LGD may have a higher risk for esophageal cancer than previously realised. The scientists find that careful assessment in these cellular changes could prevent LGD over-diagnosis. This careful approach could lead to LGD diagnoses with greater confidence and, consequently, improved targeting of those patients at risk of cancer of the esophagus.

Source: American Journal of Gastroenterology

* DOI: 10.1038/ajg.2010.171