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Prisma Health encourages patients to monitor for risks of esophageal cancer associated with GERD

Thursday, June 24, 2021

GREENVILLE, S.C.—Prisma Health is encouraging individuals with a longstanding history of gastroesophageal reflux disease (GERD) to be conscious of the risk of developing Barrett’s esophagus and esophageal cancer. The most common symptoms of reflux disease are:

  • Heartburn, a burning feeling in the chest
  • Regurgitation, when acid and undigested food flow back into the throat or mouth

GERD occurs when stomach acid or bile flows backward into the esophagus and irritates the lining. Chronic acid reflux may result in a change in the lining of the esophagus called Barrett’s esophagus, a condition seen by about 10-15 percent of GERD patients. Among patients who have Barrett’s esophagus, the risk of developing esophageal cancer is increased above that of the general population, but the overall risk of developing cancer in patients with Barrett's esophagus is still minimal.

Gastroesophageal reflux disease is associated with a six to seven times increased likelihood of developing esophageal adenocarcinoma, and 60 percent of patients with this cancer report a history of GERD. Most people with chronic GERD, however, do not develop esophageal adenocarcinoma, and predicting progression remains difficult.

“Antacids or acid suppressants are good at improving the quality of life in people with acid reflux, but we are not sure if they help to prevent Barrett’s esophagus or potentially even esophageal cancer. It is not uncommon for us to see patients who have been experiencing symptoms of esophageal cancer for some time, leading to a more advanced cancer by the time it is identified,” said Madhusudhan Sunkavalli, MD, a gastroenterologist at Prisma Health.

As of now, there are no established guidelines for screening patients for esophageal cancer. About 93% of diagnoses of esophageal adenocarcinoma are made while investigating patients with symptoms such as difficulty swallowing, painful swallowing, recurrent vomiting, unexplained weight loss, anemia, appetite loss or gastrointestinal bleeding, which can be associated with late-stage adenocarcinoma. Increased screening is suggested, but not required, by the American Society of Gastrointestinal Endoscopy for high-risk patients, defined as those with a family history of esophageal cancer or Barrett’s esophagus or patients with GERD and one other risk factor.

At-risk patients should focus on prevention of esophageal cancer by monitoring additional risk factors. The most important risk factors include Barrett's esophagus diagnosis, over 50 years of age, GERD, being male, family history of Barrett’s esophagus or esophageal cancer, abdominal obesity and smoking.

About Prisma Health

Prisma Health is a not-for-profit health company and the largest healthcare system in South Carolina. With nearly 30,000 team members, 18 acute care and specialty hospitals, 2,947 beds, approximately 300 outpatient sites, and nearly 5,000 employed and clinically integrated network physicians and providers, Prisma Health serves more than 1.2 million unique patients annually in its 21-county market area that covers 50% of South Carolina. Prisma Health’s goal is to improve the health of all South Carolinians by enhancing clinical quality, the patient experience and access to affordable care, as well as conducting clinical research and training the next generation of medical professionals. For more information, visit PrismaHealth.org.

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