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Australian clinical practice guidelines for the diagnosis and management of Barrett's esophagus and early esophageal adenocarcinoma
Authors:David C Whiteman  Mark Appleyard  Farzan F Bahin  Yuri V Bobryshev  Michael J Bourke  Ian Brown  Adrian Chung  Andrew Clouston  Emma Dickins  Jon Emery  Guy D Eslick  Louisa G Gordon  Florian Grimpen  Geoff Hebbard  Laura Holliday  Luke F Hourigan  Bradley J Kendall  Eric YT Lee  Angelique Levert‐Mignon  Reginald V Lord  Sarah J Lord  Derek Maule  Alan Moss  Ian Norton  Ian Olver  Darren Pavey  Spiro Raftopoulos  Shan Rajendra  Mark Schoeman  Rajvinder Singh  Freddy Sitas  B Mark Smithers  Andrew C Taylor  Melissa L Thomas  Iain Thomson  Henry To  Jutta von Dincklage  Christine Vuletich  David I Watson  Ian F Yusoff
Affiliation:1. QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia;2. Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia;3. Westmead Hospital, Sydney, New South Wales, Australia;4. Westmead Clinical School, University of Sydney, Sydney, New South Wales, Australia;5. University of New South Wales, Sydney, New South Wales, Australia;6. St Vincent's Centre for Applied Medical Research, Sydney, New South Wales, Australia;7. Envoi Pathology, Brisbane, Queensland, Australia;8. Flinders Medical Centre, Adelaide, South Australia, Australia;9. Cancer Council Australia, Sydney, New South Wales, Australia;10. University of Melbourne, Melbourne, Victoria, Australia;11. University of Sydney, Sydney, New South Wales, Australia;12. Griffith University, Brisbane, Queensland, Australia;13. Royal Melbourne Hospital, Melbourne, Victoria, Australia;14. Princess Alexandra Hospital, University of Queensland, Brisbane, Queensland, Australia;15. School of Medicine, University of Notre Dame Australia, Sydney, New South Wales, Australia;16. Cancer Council New South Wales, Sydney, New South Wales, Australia;17. Western Health, Melbourne, Victoria, Australia;18. Royal North Shore Hospital, Sydney, New South Wales, Australia;19. Bankstown and Concord Hospitals, Sydney, New South Wales, Australia;20. Sir Charles Gairdner Hospital, Perth, Western Australia, Australia;21. Bankstown‐Lidcombe Hospital, Sydney, New South Wales, Australia;22. Royal Adelaide Hospital, Adelaide, South Australia, Australia;23. University of Adelaide, Adelaide, South Australia, Australia;24. The Lyell McEwin Hospital, Adelaide, South Australia, Australia;25. St Vincent's Hospital, Melbourne, Victoria, Australia;26. Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
Abstract:Barrett's esophagus (BE), a common condition, is the only known precursor to esophageal adenocarcinoma (EAC). There is uncertainty about the best way to manage BE as most people with BE never develop EAC and most patients diagnosed with EAC have no preceding diagnosis of BE. Moreover, there have been recent advances in knowledge and practice about the management of BE and early EAC. To aid clinical decision making in this rapidly moving field, Cancer Council Australia convened an expert working party to identify pertinent clinical questions. The questions covered a wide range of topics including endoscopic and histological definitions of BE and early EAC; prevalence, incidence, natural history, and risk factors for BE; and methods for managing BE and early EAC. The latter considered modification of lifestyle factors; screening and surveillance strategies; and medical, endoscopic, and surgical interventions. To answer each question, the working party systematically reviewed the literature and developed a set of recommendations through consensus. Evidence underpinning each recommendation was rated according to quality and applicability.
Keywords:Barrett's esophagus  clinical practice  esophageal adenocarcinoma  guidelines
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