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