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Closer surveillance of patients with severe chronic heartburnheartburn and Barrett's would lead to even better survival, Peters says.
But there is much debate about just how intensive this surveillance should be. Barrett's esophagus is considered a pre-malignant condition, but 90% of people with Barrett's esophagus never get esophageal cancer, according to the American College of Gastroenterology.
Even with rigorous surveillance of Barrett's esophagus patients, a large percentage of esophageal cancers will continue to be diagnosed late in the disease when the chances of survival are poor, says Rhonda Souza, MD. She points out that one recent study found that 95% of people with Barrett's esophagus didn't even know they had the condition.
Souza is an associate professor of medicine at University of Texas Southwestern Medical Center at Dallas and the Dallas Veteran's Administration.
"The problem is not that we are missing esophageal cancer in the people we screen, but that the vast majority of high-risk people are not being followed," she says. "Until we have a better way to identify patients with Barrett's esophagus, surveillance will only take us so far."