Latest news with #BarrettsEsophagus
Medscape
a day ago
- Health
- Medscape
Less Invasive Screening May Identify Barrett's Earlier
A new combination modality demonstrated excellent sensitivity and negative predictive value compared with endoscopy in a prospective study of at-risk veterans screened for Barrett's esophagus (BE) and esophageal adenocarcinoma (EAC), a small comparative study in US veterans found. BE is up to three times more prevalent in veterans than in the general population. This and other minimally invasive approaches may reduce patient anxiety and increase screening rates, according to investigators led by Katarina B. Greer, MD, MS, of the VA Northeast Ohio Healthcare System and Case Western University in Cleveland. Such screening platforms are expected to open a window on improved prognosis for EAC by offering well-tolerated, office-based testing, the authors wrote in The American Journal of Gastroenterology. Greer and colleagues compared standard upper endoscopy with EsoCheck (EC), a nonendoscopic esophageal balloon cell-sampling device coupled with EsoGuard (EG), a DNA-based precancer screening assay, with standard upper endoscopy, an FDA-approved minimally invasive alternative. Sensitivity and specificity of combined EC/EG for esophagogastroduodenoscopy (EGD)-detected BE/EAC were 92.9% (95% CI, 66.1-99.8) and 72.2% (95% CI, 62.1-80.8), respectively. Positive and negative predictive values were 32.5% (95% CI, 18.6-49.1) and 98.6% (95% CI, 92.4-100), respectively. 'With its strong negative predictive power, this screening modality could be a first-line tool available to a greater number of patients,' Greer and associates wrote. 'Data from this test support the notion that EC could be performed as a triaging test to increase the yield of diagnostic upper endoscopy 2.5-fold.' The US rates of EAC have increased more than six-fold in the past four decades and continue to rise. In 2023, 21,560 cases of EAC were diagnosed here. The prognosis for EAC is still poor, with fewer than 22% of patients surviving beyond 5 years. Current guidelines recommend sedated EGD for patients with chronic gastroesophageal reflux disease (GERD) and additional BE risk factors such as smoking, obesity, and family history. This strategy, however, often fails to detect BE when symptoms are well controlled with over-the-counter or physician-prescribed therapies, Greer and colleagues noted. It also fails to detect BE in individuals without GERD, who comprise 40% of those who develop EAC. Fewer than 5% of EACs are diagnosed as early-stage lesions caught by surveillance of patients with previously detected BE. Study Details The researchers recruited veterans meeting American College of Gastroenterology criteria for endoscopic BE and EAC screening at the Louis Stokes Cleveland Veterans Affairs Medical Center. Of 782 eligible veterans, 130 (16.6%) entered the study and 124 completed screening. Common reasons for nonparticipation included completion of upper endoscopy outside of the VA healthcare system, lack of interest in joining a research study, and no recommendation for screening from referring gastroenterology or primary care providers. Eligible candidates had gastroesophageal reflux disorder plus three additional risk factors, such as smoking, higher BMI, male sex, age 50 years or older, and family history. The mean number of risk factors was 4.1. 'Available data suggest that family history is the strongest predictor of BE diagnosis, as prevalence of BE among those with family history was 23%,' Greer's group wrote. 'This points to high priority of pursuing screening in patients with family history of the condition, followed by patients who share multiple risk factors.' All participants completed unsedated EC-guided distal esophageal sampling followed by a sedated EGD on the same day. The prevalence of BE/EAC was 12.9% (n = 14/2), based on standard EGD. 'The study was not powered to prospectively determine EC diagnostic accuracy for subgroups of nondysplastic and dysplastic BE and EAC. These data are reported for this device in development studies but not available for our study population,' the authors wrote. In comparison, they noted, the Cytosponge-TFF3, another nonendoscopic screening device for EAC and BE, exhibited lower sensitivity of 79.5%-87.2%, depending on lesion length, but higher specificity of 92.4%. Procedural Anxiety Baseline scores on the short-form six-item Spielberger State-Trait Anxiety Inventory-6 (STAI-6) revealed notable levels of periprocedural anxiety. STAI-6 scores range from 20 to 80, with higher scores indicating more severe anxiety. In the VA study, scores ranged from 20 to 60, and most domains constituting the scores were the same before and after the procedure. Participants did, however, report a statistically significant decrease in sense of worry after EC and reported good tolerability for both EC and EG. Offering an outsider's perspective on the study, Joshua Sloan, DO, an esophageal gastroenterologist at University of Minnesota Medical Center in Minneapolis, said that with the acceleration of US rates of EAC, developing a nonendoscopic screening tool to improve identification of Barrett's and perhaps early EAC is important. 'The study by Greer et al helps support the use of nonendoscopic screening with EsoCheck and EsoGuard to identify these conditions,' he told Medscape Medical News. 'It will be interesting to see similar studies in the non-VA population as well. As the study notes, veterans are an enriched population with a higher prevalence of Barrett's esophagus.' Ultimately, Sloan added, 'the hope is to increase our ability to identify and manage BE before it becomes EAC. Nonendoscopic screening tools have the potential to increase diagnosis and funnel the appropriate patients for endoscopic surveillance.' The Bottom Line 'Calculations regarding effectiveness of the two-step screening strategy afforded by EC indicate that the burden of screening would be reduced by at least half (53%),' the authors wrote. Since the estimated size of the US screen-eligible population ranges from 19.7 million to 120.1 million, noninvasive tools could significantly decrease EGD procedures. A formal cost effectiveness analysis is being conducted and will be published separately. This study was funded by a Department of Defense award.
Yahoo
23-05-2025
- Business
- Yahoo
Trends Shaping the Barrett's Esophagus (BE) Industry, 2025-2030: Technological Advances in Diagnostics Elevate BE Surveillance
Dublin, May 23, 2025 (GLOBE NEWSWIRE) -- The "Barrett's Esophagus - Global Strategic Business Report" has been added to global market for Barrett's Esophagus was valued at US$4.9 Billion in 2024 and is projected to reach US$6.1 Billion by 2030, growing at a CAGR of 3.9% from 2024 to 2030. This comprehensive report provides an in-depth analysis of market trends, drivers, and forecasts, helping you make informed business decisions. The report includes the most recent global tariff developments and how they impact the Barrett's Esophagus growth in the Barrett's Esophagus market is underpinned by a confluence of epidemiological, technological, and policy drivers. Increasing GERD burden, combined with greater public and physician awareness of BE-cancer progression risks, is elevating demand for routine screening and early intervention. Health systems are recognizing the cost-effectiveness of preventing esophageal cancer through proactive BE management, prompting wider adoption of minimally invasive diagnostics and ablation endorsements of new imaging and therapeutic tools, coupled with industry efforts to bundle diagnostic and treatment platforms, are streamlining the care pathway. Cross-disciplinary collaboration and data-sharing via registries are enhancing outcome transparency and evidence-based decision-making. As healthcare moves toward precision medicine and value-based care, a critical question emerges: Can the BE market continue to integrate early detection with personalized intervention strategies to deliver scalable, cost-effective cancer prevention across global care settings?Report ScopeThe report analyzes the Barrett's Esophagus market, presented in terms of market value (US$ Thousand). The analysis covers the key segments and geographic regions outlined Drug Class (Proton Pump Inhibitors, H2 Receptor Antagonists, Mucosal Protective Agents, Other Drug Classes); Distribution Channel (Hospital Pharmacies, Retail Pharmacies, Online Pharmacies).Geographic Regions/Countries: World; United States; Canada; Japan; China; Europe (France; Germany; Italy; United Kingdom; Spain; Russia; and Rest of Europe); Asia-Pacific (Australia; India; South Korea; and Rest of Asia-Pacific); Latin America (Argentina; Brazil; Mexico; and Rest of Latin America); Middle East (Iran; Israel; Saudi Arabia; United Arab Emirates; and Rest of Middle East); and Insights: Market Growth: Understand the significant growth trajectory of the Proton Pump Inhibitors segment, which is expected to reach US$2.4 Billion by 2030 with a CAGR of a 2.9%. The H2 Receptor Antagonists segment is also set to grow at 4.7% CAGR over the analysis period. Regional Analysis: Gain insights into the U.S. market, valued at $1.3 Billion in 2024, and China, forecasted to grow at an impressive 6.9% CAGR to reach $1.2 Billion by 2030. Discover growth trends in other key regions, including Japan, Canada, Germany, and the Asia-Pacific. Key Questions Answered: How is the Global Barrett's Esophagus Market expected to evolve by 2030? What are the main drivers and restraints affecting the market? Which market segments will grow the most over the forecast period? How will market shares for different regions and segments change by 2030? Who are the leading players in the market, and what are their prospects? Report Features: Comprehensive Market Data: Independent analysis of annual sales and market forecasts in US$ Million from 2024 to 2030. In-Depth Regional Analysis: Detailed insights into key markets, including the U.S., China, Japan, Canada, Europe, Asia-Pacific, Latin America, Middle East, and Africa. Company Profiles: Coverage of players such as AbbVie Inc., Abbott Laboratories, Addex Therapeutics Ltd., Aurobindo Pharma Ltd., Bayer AG and more. Complimentary Updates: Receive free report updates for one year to keep you informed of the latest market developments. Some of the 34 companies featured in this Barrett's Esophagus market report include: AbbVie Inc. Abbott Laboratories Addex Therapeutics Ltd. Aurobindo Pharma Ltd. Bayer AG Boehringer Ingelheim GmbH Boston Scientific Corporation Castle Biosciences Cipla Inc. Cook Medical Inc. Dr. Reddy's Laboratories Ltd. Eisai Co., Ltd. Eli Lilly and Company F. Hoffmann-La Roche Ltd. GlaxoSmithKline plc Johnson & Johnson Lupin Limited Medtronic plc Merck & Co., Inc. Novartis AG Tariff Impact Analysis: Key Insights for 2025Global tariff negotiations across 180+ countries are reshaping supply chains, costs, and competitiveness. This report reflects the latest developments as of April 2025 and incorporates forward-looking insights into the market analysts continuously track trade developments worldwide, drawing insights from leading global economists and over 200 industry and policy institutions, including think tanks, trade organizations, and national economic advisory bodies. This intelligence is integrated into forecasting models to provide timely, data-driven analysis of emerging risks and Included in This Edition: Tariff-adjusted market forecasts by region and segment Analysis of cost and supply chain implications by sourcing and trade exposure Strategic insights into geographic shifts Buyers receive a free July 2025 update with: Finalized tariff impacts and new trade agreement effects Updated projections reflecting global sourcing and cost shifts Expanded country-specific coverage across the industry Key Attributes Report Attribute Details No. of Pages 274 Forecast Period 2024-2030 Estimated Market Value (USD) in 2024 $4.9 Billion Forecasted Market Value (USD) by 2030 $6.1 Billion Compound Annual Growth Rate 3.9% Regions Covered Global MARKET OVERVIEW Influencer Market Insights World Market Trajectories Barrett's Esophagus Global Key Competitors Percentage Market Share in 2025 (E) Competitive Market Presence Strong/Active/Niche/Trivial for Players Worldwide in 2025 (E) MARKET TRENDS & DRIVERS Rising GERD Prevalence Drives Demand for Early Screening and Diagnosis of Barrett's Esophagus Advancements in Endoscopic Imaging and Biopsy Tools Improve Detection Accuracy High-Risk Patient Monitoring Through Surveillance Programs Fuels Use of Specialized Devices Minimally Invasive Treatment Modalities Like RFA and Cryotherapy Expand Therapeutic Reach Clinical Guidelines Emphasize Early Intervention to Prevent Progression to Esophageal Adenocarcinoma Biomarker Research Enhances Risk Stratification and Personalized Surveillance Protocols Growing Awareness of Barrett's Risk Factors Spurs Referrals From Primary Care to GI Specialists EHR Integration and Registry Participation Improve Patient Tracking and Longitudinal Outcomes AI-Based Image Analysis Tools Support Enhanced Detection in Diagnostic Endoscopy Device Manufacturers Focus on Comfort, Precision, and Workflow Efficiency in Diagnostic Kits Health System Adoption of Barrett's Pathways Improves Standardization of Care Delivery Expansion of Digestive Health Programs in Hospitals Elevates Focus on Esophageal Precancers For more information about this report visit About is the world's leading source for international market research reports and market data. We provide you with the latest data on international and regional markets, key industries, the top companies, new products and the latest trends. CONTACT: CONTACT: Laura Wood,Senior Press Manager press@ For E.S.T Office Hours Call 1-917-300-0470 For U.S./ CAN Toll Free Call 1-800-526-8630 For GMT Office Hours Call +353-1-416-8900Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
Medscape
15-05-2025
- Health
- Medscape
No Barrett's Survival Benefit With Regular Surveillance
SAN DIEGO—Gastroenterologists have debated the best course of action for patients with Barrett's esophagus for decades. Which is better for detecting early malignancy and preventing progression to esophageal adenocarcinoma (EAC) — surveillance endoscopy at regular intervals or only when symptoms occur? Does one offer a better chance of survival than the other? Now, researchers who conducted what they believe is the first randomized clinical trial comparing the two approaches say they have the answer. Surveillance endoscopy every 2 years offers no benefit in terms of overall or cancer-specific survival, said Oliver Old, MD, a consultant upper-GI surgeon at Gloucestershire Royal Hospital, England, who presented the findings at Digestive Disease Week (DDW) 2025. At-need endoscopy may be a safe alternative for low-risk patients, the research team concluded. The BOSS Trial The Barrett's Oesophagus Surveillance Versus Endoscopy At Need Study (BOSS) ran from 2009 to 2024 at 109 centers in the UK, and 3452 patients with Barrett's esophagus of 1 cm circumferential or a 2 cm noncircumferential tongue or island were followed for a minimum of 10 years. Researchers randomly assigned patients to undergo upper gastrointestinal endoscopy with biopsy every 2 years (the standard of care when the trial was set up) or endoscopy 'at-need' when symptoms developed. Patients in the latter group were counseled about risk and were offered endoscopy for a range of alarm symptoms. The study found no statistically significant difference in all-cause mortality risk between the two groups. Over the study period, 333 of 1733 patients (19.2%) in the surveillance group died, as did 356 of 1719 patients (20.7%) in the at-need group. Similarly, no statistically significant between-group difference was found in the risk for cancer-specific mortality. About 6.2% of patients died from cancer in both groups — 108 in the regular surveillance group and 106 in the at-need group. Nor was there a statistically significant difference in diagnosis of EAC, with 40 regular surveillance patients (2.3%) and 31 at-need patients (1.8%) receiving the diagnosis over median follow-up of 12.8 years. Cancer stage at diagnosis did not differ significantly between groups. 'The really low rate of progression to esophageal adenocarcinoma' was a key finding, Old said. The rate of progression to EAC was 0.23% per patient per year, he said. Low- or high-grade dysplasia was detected in 10% of patients in the regular surveillance group, compared with 4% in the at-need group. The mean interval between endoscopies was 22.9 months for the regular surveillance group and 31.5 months for the at-need group, and the median interval was 24.8 months and 25.7 months, respectively. The mean number of endoscopies was 3.5 in the regular surveillance group and 1.4 in the at-need group. Eight patients in the regular surveillance group (0.46%) and seven in the at-need group (0.41%) reported serious adverse events. Will BOSS Change Minds? Current surveillance practices 'are based on pure observational data, and the question of whether surveillance EGD [esophagogastroduodenoscopy] impacts EAC diagnosis and mortality has been ongoing,' said Margaret Zhou, MD, MS, clinical assistant professor at Stanford University School of Medicine, Stanford, California. A randomized clinical trial on the subject has been needed for years, she added. However, Zhou said, 'In my opinion, this study does not end the debate and will not change my practice of doing surveillance endoscopy on NDBE [nondysplastic Barrett's esophagus], which I typically perform every 3-5 years, based on current guidelines.' The American Gastroenterological Association clinical practice guideline, issued in June 2024, addresses surveillance and focuses on a patient-centered approach when deciding on treatment or surveillance. Patients in the at-need endoscopy arm underwent endoscopy almost as frequently as the patients randomly assigned to regular surveillance, at a median interval of about 2 years, Zhou noted. Therefore, she said, 'It's difficult to conclude from this study that surveillance endoscopy has no impact.' Additionally, the study was underpowered to detect a difference in all-cause mortality and assumed a progression rate for nondysplastic Barrett's esophagus that is higher than the current understanding, Zhou said. 'It also did not address the important question of EAC-related mortality, which would be an important outcome to be able to assess whether surveillance EGD has an impact,' she said. Joel H. Rubenstein, MD, MSc, director of the Barrett's Esophagus Program and professor in the Division of Gastroenterology at the University of Michigan Medical School, Ann Arbor, agreed that the study doesn't answer the pressing question of whether surveillance works. While Rubenstein said he would not tell colleagues or patients to stop routine surveillance in patients with Barrett's esophagus on the basis of these results, 'it is a reminder that we should be circumspect in who we label as having Barrett's esophagus, and we should be more proactive in discussing discontinuation of surveillance in patients based on advancing age and comorbidities.'
