Overutilization of endoscopic surveillance in nondysplastic Barrett's esophagus: a multicenter study.

Published

Journal Article

Guidelines suggest that patients with nondysplastic Barrett's esophagus (BE) undergo endoscopic surveillance every 3 to 5 years, but actual use of surveillance endoscopy and the determinants of variation in surveillance intervals are not known.To measure use of surveillance endoscopy and its variation in patients with nondysplastic BE.Multicenter, cross-sectional study.Three sites in Arizona, Minnesota, and North Carolina.This study involved patients who had prevalent BE without a history of high-grade dysplasia or esophageal adenocarcinoma.Participants were given validated measures of quality of life, numeracy, and cancer risk perception, and the total number of prior endoscopic surveillance examinations was measured.Oversurveillance was defined as >1 surveillance examination per 3-year period.Among 235 patients with nondysplastic BE, 76% were male and 94% were white. The average (± standard deviation [SD]) duration of BE was 6.5 ± 5.9 years. The mean (± SD) number of endoscopies per 3-year period was 2.7 ± 2.6. Oversurveillance was present in 65% of participants, resulting in a mean of 2.3 excess endoscopies per patient. Neither numeracy skills nor patient perception of cancer risk were associated with oversurveillance.Endoscopies were measured by patient report, which is subject to error. Results may be generalizable only to patients seen in academic centers.Most patients with nondysplastic BE had more surveillance endoscopic examinations than is recommended by published guidelines. Patient factors did not predict oversurveillance, indicating that other factors may influence decisions about the interval and frequency of surveillance examinations.

Full Text

Duke Authors

Cited Authors

  • Crockett, SD; Lipkus, IM; Bright, SD; Sampliner, RE; Wang, KK; Boolchand, V; Lutzke, LS; Shaheen, NJ

Published Date

  • January 2012

Published In

Volume / Issue

  • 75 / 1

Start / End Page

  • 23 - 31.e2

PubMed ID

  • 22100301

Pubmed Central ID

  • 22100301

Electronic International Standard Serial Number (EISSN)

  • 1097-6779

International Standard Serial Number (ISSN)

  • 0016-5107

Digital Object Identifier (DOI)

  • 10.1016/j.gie.2011.08.042

Language

  • eng