What is the risk of developing adenocarcinoma of the esophagus in Barretts?
When patients with Barrett’s esophagus are assessed as a group, the risk of cancer has been found to be as low as one in 300 patients yearly. This means that if we examined 300 patients yearly, one patient would be found to have cancer every year. What we really need to know, however, is the risk of cancer if NO DYSPLASIA is found after one or two years of surveillance. Our belief is that this risk would be much less than the previously-quoted figures of one in 300 patients yearly. Among patients with high grade dysplasia, up to 50% may be found to have cancer. Therefore, the first order of management when high grade dysplasia is found is to exclude the presence of an adenocarcinoma. Low grade dysplasia is much less threatening than high grade dysplasia, but we don’t know just how much less. In fact, we don’t have precise data to indicate just what the cancer risk is in patients with Barrett’s and low grade dysplasia. The diagnosis of dysplasia should be as precise as possible because
