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Risk of Upper Gastrointestinal Cancers in Patients With Gastroesophageal Reflux Disease After a Negative Screening Endoscopy.
[esophageal adenocarcinoma]
Practice
guidelines
recommend
a
1
-
time
screening
endoscopy
for
patients
with
gastroesophageal
reflux
disease
(
GERD
)
who
are
at
high
risk
for
Barrett
's
esophagus
or
malignancy
.
However
,
little
is
known
about
the
risk
of
cancer
in
patients
with
negative
findings
from
screening
endoscopies
.
We
conducted
a
retrospective
cohort
study
using
data
from
121
Veterans
Health
Administration
facilities
nationwide
to
determine
the
incidence
rate
of
esophageal
adenocarcinoma
(
EA
)
separately
,
as
well
as
any
upper
gastrointestinal
cancers
,
in
patients
with
an
initial
negative
screening
endoscopy
(
esophagogastroduodenoscopy
[
EGD
]
)
.
We
included
veteran
patients
with
GERD
diagnosed
between
2004
and
2009
who
had
a
negative
screening
EGD
within
1
year
of
diagnosis
.
We
estimated
the
incidence
rate
of
EA
,
and
any
upper
gastrointestinal
cancer
,
in
patients
with
GERD
who
had
a
negative
screening
EGD
.
We
examined
differences
in
demographic
,
clinical
,
and
facility
factors
among
patients
with
and
without
cancer
.
We
identified
68
,
610
patients
with
GERD
and
a
negative
screening
EGD
(
mean
age
,
55
.
5
y
;
90
%
men
;
67
.
5
%
white
)
.
During
a
mean
follow-up
period
of
3
.
2
years
,
10
patients
developed
EA
and
29
patients
developed
any
upper
gastrointestinal
malignancies
,
including
EA
.
The
incidence
of
subsequent
EA
in
this
group
was
4
.
6
/
100
,
000
patient-
years
of
follow-up
evaluation
,
whereas
the
incidence
of
any
upper
gastrointestinal
cancers
was
13
.
2
/
100
,
000
patient-
years
of
follow-up
evaluation
.
Patients
with
a
subsequent
cancer
were
significantly
older
and
had
higher
comorbidity
scores
than
patients
without
cancer
.
Other
clinical
and
facility
factors
did
not
differ
significantly
between
these
2
groups
.
The
risk
of
cancer
is
low
,
over
a
mean
3
-
year
period
,
for
patients
with
GERD
who
had
a
negative
screening
endoscopy
.
These
findings
justify
recommendations
for
a
1
-
time
screening
endoscopy
for
patients
with
GERD
.
Diseases
Validation
Diseases presenting
"cancer"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
alpha-thalassemia
benign recurrent intrahepatic cholestasis
cadasil
canavan disease
carcinoma of the gallbladder
cholangiocarcinoma
coats disease
congenital adrenal hyperplasia
congenital diaphragmatic hernia
cowden syndrome
cushing syndrome
cutaneous mastocytosis
dedifferentiated liposarcoma
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erdheim-chester disease
erythropoietic protoporphyria
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
familial hypocalciuric hypercalcemia
familial mediterranean fever
gm1 gangliosidosis
heparin-induced thrombocytopenia
hereditary cerebral hemorrhage with amyloidosis
hirschsprung disease
hodgkin lymphoma, classical
inclusion body myositis
junctional epidermolysis bullosa
kabuki syndrome
kallmann syndrome
kindler syndrome
lamellar ichthyosis
liposarcoma
locked-in syndrome
lymphangioleiomyomatosis
monosomy 21
neuralgic amyotrophy
oculocutaneous albinism
oligodontia
oral submucous fibrosis
papillon-lefèvre syndrome
pendred syndrome
pleomorphic liposarcoma
primary effusion lymphoma
proteus syndrome
pyomyositis
pyruvate dehydrogenase deficiency
severe combined immunodeficiency
sneddon syndrome
systemic capillary leak syndrome
triple a syndrome
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
werner syndrome
wiskott-aldrich syndrome
wolf-hirschhorn syndrome
x-linked adrenoleukodystrophy
This symptom has already been validated