| Theme |
Up‒to‒date of the Protection of Gastroenterological Cancers |
| Title |
Reflux Esophagitis and Esophageal Adenocarcinoma |
| Author |
Yuji Amano |
Division of Endoscopy, Kaken Hospital, International University of Health and Welfare |
| Author |
Takane Azumi |
Division of Endoscopy, Kaken Hospital, International University of Health and Welfare |
| Author |
Masaru Tsuboi |
Department of Gastroenterology, Kaken Hospital, International University of Health and Welfare |
| Author |
Shigeatsu Motoori |
Department of Gastroenterology, Kaken Hospital, International University of Health and Welfare |
| [ Summary ] |
The incidence of adenocarcinoma derived from Barrett's esophagus has been steadily increasing over the past several decades in Western countries. On the other hand, in Japan, most cases of esophageal cancer are squamous cell carcinomas, not adenocarcinomas. However, the recent increase in the number of cases of Barrett's esophagus with subsequent esophageal adenocarcinoma has become worrisome in Japan, since the number of patients with gastro‒esophageal reflux disease is markedly increasing. Therefore, a strategy for the clinical management of Barrett's esophagus in Japanese patients has gained interest. The endoscopic diagnosis of esophageal adenocarcinoma requires skillful and effective maneuvers including the use of image‒enhanced endoscopy to diagnose at an earlier stage. In order to avoid Barrett's carcinogenesis, some procedures such as chemoprevention by the administration of non‒steroidal anti‒inflammatory drugs (NSAIDs), aspirin, proton‒pump inhibitors (PPI), and statins, and endoscopic surgery including endoscopic mucosal resection and coagulation for patients with Barrett's esophagus may become necessary in the near future. However, there are many issues relating to the pathophysiology, epidemiology, and surveillance methods of Barrett’s esophagus in Japanese patients that must be resolved as soon as possible. |