Premalignant Conditions of the Esophagus

Abstract

Esophageal cancer has often poor survival when it is diagnosed at the time of clinical symptoms. Precancerous lesions of the esophagus are targets of interest in selected group of patients with important risk factors. Barrett's esophagus - intestinal metaplasia is the main precursor lesion for the development of esophageal adenocarcinoma, the tumor with increased incidence. The major risk factor for Barrett's esophagus is longterm gastroesophageal reflux disease. In addition to antireflux therapy, the endoscopic surveillance and followup are scheduled in order to detect adenocarcinoma and its precursor dysplastic lesions at an early and curable stage. The patients with achalasia, caustic injury of the esophagus and those with head and neck cancer are at increased risk of development of the squamous cell esophageal cancer. The aim of this paper is to provide an overview of the risk factors, epidemiology, screening and surveillance of premalignant lesions of the esophagus. Recent endoscopic and surgical procedures to treat advanced dysplastic lesions and early cancer are discussed.