Surveillance in Barrett's Esophagus: A Failed Premise

Surveillance in Barrett Esophagus

The only known precursor of the esophageal adenocarcinoma (EAC) is represented by the Barrett's esophagus (BE). EAC incidence has increased sharply in the last 4 decades. The annual conversion rate of BE to cancer is small but significant; therefore the identification of patients at a higher risk of cancer represents a dilemma. The endoscopic surveillance of BE aims to detect dysplasia and in p...

Surveillance of Barrett's esophagus.

The problems with surveillance of Barrett's esophagus.

In patients with Barrett’s esophagus, the native squamous epithelium of the esophagus is replaced by metaplastic columnar epithelium that is subject to dysplasia and mutation into esophageal adenocarcinoma. The incidence of esophageal adenocarcinoma, a particularly lethal form of cancer, increased by a factor of 6 in the United States between 1975 and 2001.1 Identified risk factors for esophage...

Endoscopic surveillance of patients with Barrett esophagus.

I propose that a patient with a clinical diagnosis of Barrett’s oesophagus (BO) must have regularly endoscopic surveillance and protocol biopsy. BO is defined by endoscopically visible oesophageal columnar epithelium with intestinal metaplasia. The purpose of screening is detection of dysplastic change and early cancer, to allow early intervention and prevention of the suffering of symptomatic ...

Interventions in Premise Semantics

Counterfactual thought and talk play a central role throughout science and in many areas of philosophy. Hence it’s not surprising that they have been extensively studied in a number fields: besides philosophy itself, linguistics, psychology, and computer science. In particular, much work has gone into developing a logic and a semantics for counterfactual conditionals, i.e. conditionals of the f...