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Article: Multinational survey on the preferred approach to management of Barrett's esophagus in the Asia-Pacific region

TitleMultinational survey on the preferred approach to management of Barrett's esophagus in the Asia-Pacific region
Authors
KeywordsBarrett's esophagus
Survey
Asia-Pacific
Asian Barrett's consortium
Prague criteria
Issue Date2021
PublisherBaishideng Publishing Group Co., Limited. The Journal's web site is located at http://www.wjgnet.com/1948-5204/e-journal.htm
Citation
World Journal of Gastrointestinal Oncology, 2021, v. 13 n. 4, p. 279-294 How to Cite?
AbstractBACKGROUND Major societies provide differing guidance on management of Barrett’s esophagus (BE), making standardization challenging. AIM To evaluate the preferred diagnosis and management practices of BE among Asian endoscopists. METHODS Endoscopists from across Asia were invited to participate in an online questionnaire comprising eleven questions regarding diagnosis, surveillance and management of BE. RESULTS Five hundred sixty-nine of 1016 (56.0%) respondents completed the survey, with most respondents from Japan (n = 310, 54.5%) and China (n = 129, 22.7%). Overall, the preferred endoscopic landmark of the esophagogastric junction was squamo-columnar junction (42.0%). Distal palisade vessels was preferred in Japan (59.0% vs 10.0%, P < 0.001) while outside Japan, squamo-columnar junction was preferred (59.5% vs 27.4%, P < 0.001). Only 16.3% of respondents used Prague C and M criteria all the time. It was never used by 46.1% of Japanese, whereas 84.2% outside Japan, endoscopists used it to varying extents (P < 0.001). Most Asian endoscopists (70.8%) would survey long-segment BE without dysplasia every two years. Adherence to Seattle protocol was poor with only 6.3% always performing it. 73.2% of Japanese never did it, compared to 19.3% outside Japan (P < 0.001). The most preferred (74.0%) treatment of non-dysplastic BE was proton pump inhibitor only when the patient was symptomatic or had esophagitis. For BE with low-grade dysplasia, 6-monthly surveillance was preferred in 61.9% within Japan vs 47.9% outside Japan (P < 0.001). CONCLUSION Diagnosis and management of BE varied within Asia, with stark contrast between Japan and outside Japan. Most Asian endoscopists chose squamo-columnar junction to be the landmark for esophagogastric junction, which is incorrect. Most also did not consistently use Prague criteria, and Seattle protocol. Lack of standardization, education and research are possible reasons.
Persistent Identifierhttp://hdl.handle.net/10722/305451
ISSN
2023 Impact Factor: 2.5
2023 SCImago Journal Rankings: 0.749
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorKew, GS-
dc.contributor.authorSoh, AYS-
dc.contributor.authorLee, YY-
dc.contributor.authorGotoda, T-
dc.contributor.authorLi, YQ-
dc.contributor.authorZhang, Y-
dc.contributor.authorChan, YH-
dc.contributor.authorSiah, KTH-
dc.contributor.authorTong, D-
dc.contributor.authorLaw, SYK-
dc.contributor.authorRuszkiewicz, A-
dc.contributor.authorTseng, PH-
dc.contributor.authorLee, YC-
dc.contributor.authorChang, CY-
dc.contributor.authorQuach, DT-
dc.contributor.authorKusano, C-
dc.contributor.authorBhatia, S-
dc.contributor.authorWu, JCY-
dc.contributor.authorSingh, R-
dc.contributor.authorSharma, P-
dc.contributor.authorHo, KY-
dc.date.accessioned2021-10-20T10:09:34Z-
dc.date.available2021-10-20T10:09:34Z-
dc.date.issued2021-
dc.identifier.citationWorld Journal of Gastrointestinal Oncology, 2021, v. 13 n. 4, p. 279-294-
dc.identifier.issn1948-5204-
dc.identifier.urihttp://hdl.handle.net/10722/305451-
dc.description.abstractBACKGROUND Major societies provide differing guidance on management of Barrett’s esophagus (BE), making standardization challenging. AIM To evaluate the preferred diagnosis and management practices of BE among Asian endoscopists. METHODS Endoscopists from across Asia were invited to participate in an online questionnaire comprising eleven questions regarding diagnosis, surveillance and management of BE. RESULTS Five hundred sixty-nine of 1016 (56.0%) respondents completed the survey, with most respondents from Japan (n = 310, 54.5%) and China (n = 129, 22.7%). Overall, the preferred endoscopic landmark of the esophagogastric junction was squamo-columnar junction (42.0%). Distal palisade vessels was preferred in Japan (59.0% vs 10.0%, P < 0.001) while outside Japan, squamo-columnar junction was preferred (59.5% vs 27.4%, P < 0.001). Only 16.3% of respondents used Prague C and M criteria all the time. It was never used by 46.1% of Japanese, whereas 84.2% outside Japan, endoscopists used it to varying extents (P < 0.001). Most Asian endoscopists (70.8%) would survey long-segment BE without dysplasia every two years. Adherence to Seattle protocol was poor with only 6.3% always performing it. 73.2% of Japanese never did it, compared to 19.3% outside Japan (P < 0.001). The most preferred (74.0%) treatment of non-dysplastic BE was proton pump inhibitor only when the patient was symptomatic or had esophagitis. For BE with low-grade dysplasia, 6-monthly surveillance was preferred in 61.9% within Japan vs 47.9% outside Japan (P < 0.001). CONCLUSION Diagnosis and management of BE varied within Asia, with stark contrast between Japan and outside Japan. Most Asian endoscopists chose squamo-columnar junction to be the landmark for esophagogastric junction, which is incorrect. Most also did not consistently use Prague criteria, and Seattle protocol. Lack of standardization, education and research are possible reasons.-
dc.languageeng-
dc.publisherBaishideng Publishing Group Co., Limited. The Journal's web site is located at http://www.wjgnet.com/1948-5204/e-journal.htm-
dc.relation.ispartofWorld Journal of Gastrointestinal Oncology-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectBarrett's esophagus-
dc.subjectSurvey-
dc.subjectAsia-Pacific-
dc.subjectAsian Barrett's consortium-
dc.subjectPrague criteria-
dc.titleMultinational survey on the preferred approach to management of Barrett's esophagus in the Asia-Pacific region-
dc.typeArticle-
dc.identifier.emailTong, D: esodtong@hku.hk-
dc.identifier.emailLaw, SYK: slaw@hku.hk-
dc.identifier.authorityTong, D=rp02281-
dc.identifier.authorityLaw, SYK=rp00437-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.4251/wjgo.v13.i4.279-
dc.identifier.pmid33889279-
dc.identifier.pmcidPMC8040063-
dc.identifier.scopuseid_2-s2.0-85105193095-
dc.identifier.hkuros326932-
dc.identifier.volume13-
dc.identifier.issue4-
dc.identifier.spage279-
dc.identifier.epage294-
dc.identifier.isiWOS:000639956700008-
dc.publisher.placeUnited States-

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