Is there publication bias in the reporting of cancer risk in Barrett's esophagus?
GastroenterologyPublished 1 August 2000
Nicholas J. Shaheen, Melissa A. Crosby, Eugene M. Bozymski, Robert S. Sandler
Citations736
SJR quartileQ1
SJR score7.20
SNIP5.04
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TL;DR
There was a strong correlation between cancer risk and the size of the study, with small studies reporting much higher risks of cancer than larger studies, and publication bias may be overestimated in the literature due to publication bias.
Abstract
The cancer risk in BE may be overestimated in the literature due to publication bias.
Keywords
Medicine
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56,268 Citations1997Matthias Egger, George Davey Smith +2 more
Funnel plots, plots of the trials' effect estimates against sample size, are skewed and asymmetrical in the presence of publication bias and other biases Funnel plot asymmetry, measured by regression analysis, predicts discordance of results when meta-analyses are compared with single large trials.
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The American Journal of GastroenterologyUpdated Guidelines 2008 for the Diagnosis, Surveillance and Therapy of Barrett's Esophagus
2,023 Citations2008Kenneth K. Wang, Richard E. Sampliner
The guidelines for the diagnosis, surveillance and therapy of Barrett’s esophagus were originally published by the American College of Gastroenterology in 1998 and updated in 2002 and once again reviewed using the National Library of Medicine database.
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These guidelines are intended to indicate the preferable, but not the only acceptable, approach to this problem, given the wide range of specifics in any health care problem, the physician must always choose the course best suited to the individual patient and the variables in existence at the moment of decision.
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Although the incidence of esophageal adenocarcinoma is increased in patients with symptomatic Barrett's esophagus, it does not occur in the majority of such patients.
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The data indicate that Barrett's esophagus complicates gastroesophageal reflux more often than previously believed.
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467 Citations1992Brian J. Reid, Patricia L. Blount +4 more
Nine of 13 patients who showed aneuploid or increased G2/tetraploid populations in their initial flow-cytometric analysis developed high-grade dysplasia or adenocarcinoma during follow-up, but none of the 49 patients without these abnormalities progressed to high- grade dysplia or cancer.
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439 Citations1984Stuart J. Spechler, Alan H. Robbins +6 more
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365 Citations1984Stuart J. Spechler, Alan H. Robbins +6 more
Routine endoscopic and histologic surveillance for patients with Barrett's esophagus is questioned as that incidence now appears to be low, and the value of such surveillance for these patients is questioned.
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Surveillance of Barrett's patients should extend life, with incremental cost-utility ratios that compare favorably with some accepted medical practices that policy makers can compare to that of other accepted practices to determine their willingness to fund surveillance.
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Research is being conducted to determine what multimodality treatment regimens provide the best local control and survival in patients with esophageal carcinoma.
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A larger and has a longer follow-up period than previous prospective trials and demonstrates a lower incidence of adenocarcinoma in patients with Barrett's esophagus.
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Oesophageal cancer is an uncommon cause of death in patients with Barrett's oesophagus and the patients of this cohort would not have benefited from an endoscopic surveillance programme.
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312 Citations1997Kay Dickersin
This article will review the major evidence available regarding publication bias and will suggest measures for overcoming the problem.
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304 Citations1998Michael L. Callaham
Positive-outcome bias was evident when studies were submitted for consideration and was amplified in the selection of abstracts for both presentation and publication, neither of which was strongly related to study design or quality.
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272 Citations1991Michael Miros, Paul Kerlin +1 more
Persistent high grade dysplasia appears to be a sensitive indicator for the development of subsequent adenocarcinoma in Barrett's oesophagus.
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272 Citations1988C S Robertson, J F Mayberry +3 more
The high risk of malignant change makes endoscopic surveillance advisable in all patients with Barrett's oesophagus and changes in symptomatology or gross endoscopic appearances were usually absent, even after adenocarcinoma had developed, indicating that biopsy is essential for early diagnosis.
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271 Citations1992S Y Iftikhar, P D James +3 more
Length of columnar lined oesophagus seems to be a significant risk factor in the development of dysplasia and subsequent carcinoma and intensive follow up of patients with columnarlined oesphagus greater than 8 cm in length is recommended.
Archives of Internal MedicineBarrett's Esophagus
246 Citations1991Warren A. Williamson
Yearly endoscopic follow-up examination is recommended for all patients with Barrett's esophagus unless mild dysplastic changes are found, in which case surveillance should be increased, and adenocarcinoma developed in five patients for an incidence of one per 99 patient-years.
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The patients in whom antireflux surgery proved effective showed no dysplastic change or progression to adenocarcinoma, and the systematic conservative approach in the initial management of patients with Barrett's oesophagus is questioned.
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198 Citations1998David A. Katz, Richard Rothstein +4 more
If confirmed by larger follow-up studies, the results suggest that surveillance endoscopy can be safely deferred for at least 2 yr following an initial biopsy that is negative or indeterminate for dysplasia.
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192 Citations1997Allan P. Weston, PT Krmpotich +3 more
The frequency of dysplasia on the latest surveillance examination continued to be significantly higher for patients with traditional Barrett's than in patients with short segment Barrett's esophagus, and the incidence of adenocarcinoma was significantly higher.
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Classic antireflux surgery in patients with BE results in a high percentage of failures at very late follow-up because it cannot completely avoid acid and duodenal reflux into the esophagus.
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140 Citations1989Nirmal S. Mann, Ming-Chang Tsai +1 more
On medical treatment, the severity of esophagitis as judged by endoscopic criteria in BE patients was reduced, but there was no increase in lower esophageal sphincter pressure and no regression of the columnar epithelium.
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115 Citations1988Edgar Achkar, William D. Carey
An endoscopic surveillance program requiring every-other-year studies appears justified and would cost only half as much, annually as the cost of yearly endoscopicillance, estimated to be +62,000 and 78 lost work days to discover one cancer during the follow-up period.
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110 Citations1998John M. Streitz, Henry F Ellis +2 more
A cost analysis of endoscopic surveillance to detect adenocarcinoma in Barrett's esophagus compared with mammography used to detect occult carcinoma of the breast found it to be as cost-effective as surveillance mammography.
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106 Citations1989Jari Ovaska, Markku Miettinen +1 more
It is concluded that Barrett's esophagus is a potential premalignant condition and careful endoscopic surveillance for dysplasia in the columnar epithelium of the distal esophagi is mandatory in patients with Barrett's Esophagus.
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59 Citations1982Eugene M. Bozymski, KEVIN J. HERLIHY +1 more
Treatment of Barrett's esophagus is aimed at preventing gastroesophageal reflux with the additional need for close endoscopic surveillance for the development of dysplasia or early adenocarcinoma.
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49 Citations1996David B. Allison, Faith Ms +1 more
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35 Citations1993K. Moghissi, D SHARPE +1 more
Anti-reflux operation has not protected patients with Barrett's oesophagus against cancer development, and there is a higher risk of cancer development in patients witharrett's stricture compared with other patients with complications of gastro-oesophageal reflux with/without columnar epithelial-lined oesphagus and no stricture.
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It is difficult to be certain that cytomegalovirus is a pathogen, and the histological changes witnessed by Sackier and other authors may merely be a casual association, reflecting the high prevalence of the virus in immunosuppressed patients.
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10 Citations1988M Savary, J. B. Ollyo +1 more
Endoscopically, it is often impossible to distinguish between a superficial carcinoma, erythroplastic in type, and an endobrachyesophagus (EBE).