Clinical ResearchSurveillance and survival in Barrett's adenocarcinomas: A population-based study☆,☆☆
Section snippets
Data sources
The study population consisted of all esophageal and gastric cardia adenocarcinomas recorded in the Northern California Kaiser Permanente (NCKP) cancer registry between 1990 and 1998. NCKP is a large, group-model, health maintenance organization with approximately 2.7 million members. It membership is representative of the age, sex, and ethnic distributions of the San Francisco Bay Area.36 An unpublished 1999 survey sample of health plan members indicated that approximately 64% are non-Hispanic
Results
The NCKP cancer registry identified 628 adenocarcinoma patients. Eliminating duplicate reporting left 623 unique patients; medical records were available for 605 patients (96%). After record review, 16 patients without clearly documented cardia or esophageal cancers were excluded, leaving 589 total cancers for the final analysis (339 esophageal and 250 cardia cancers). A total of 64 patients (10.9%) had an EGD performed more than 6 months before their cancer diagnosis, of which 23 patients
Discussion
This study's results indicate that, among patients with esophageal and gastric cardia adenocarcinomas and a prior diagnosis of BE, surveillance-detected cancer patients have a lower stage of disease and improved survival at the end of follow-up compared with patients without surveillance-detected cancers. Despite the small patient population, there was no evidence that this surveillance-survival relationship was substantially confounded by age at BE diagnosis, year of BE or cancer diagnoses,
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Address requests for reprints to: Douglas A. Corley, M.D., M.P.H., GI 2-West, 2238 Geary Boulevard, San Francisco, California 94115. e-mail: [email protected]; fax: (415) 833-3364.
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Supported by the American Digestive Health Foundation/TAP Outcomes Research Award, and the National Institutes of Health Mentored Clinical Scientist Development Award.