Therapeutic Advances in Gastroenterology

 

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Therapeutic Advances in Gastroenterology, Vol. 1, No. 1, 7-18 (2008)
DOI: 10.1177/1756283X08093568


Reviews

Review: Chemoprevention of esophageal adenocarcinoma

Julian A. Abrams

Division of Digestive and Liver Diseases, Columbia University Medical Center New York, NY, USA, ja660{at}columbia.edu

The incidence of esophageal adenocarcinoma (EAC) is rising rapidly in Western countries, and effective chemoprevention for this malignancy is lacking. Endoscopic surveillance of patients with Barrett's esophagus is currently employed to diagnose EAC at earlier stages, but this strategy has several limitations. Non-steroidal anti-inflammatory drugs and proton pump inhibitors are the most promising agents for prevention of EAC, and a randomized controlled trial of aspirin and esomeprazole is ongoing. Other agents under investigation include green tea, berries, and antioxidants. Cost-effectiveness analyses have shown that chemopreventive agents need to be highly effective at preventing EAC in order to have benefit beyond endoscopic surveillance.

Key Words: esophageal cancer • adenocarcinoma • chemoprevention


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