Analysis of risk factors evaluation to development carcinoma and displasia of Barrett esophagus and review of Barrett's eophagus surveillance in international guidelines

• Grant number: 22/05008-9
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: July 01, 2022
• End date: June 30, 2023
• Field of knowledge: Health Sciences - Medicine - Surgery
• Principal Investigator: Marco Aurélio Santo
• Grantee: Eduardo Gallon
• Host Institution: Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil

Abstract

Barrett's esophagus (BE) is described as the replacement of the squamous epithelium of the esophageal mucosa by a columnar epithelium with goblet cells in the distal portion of the esophagus, characterizing a special intestinal metaplasia. In this context, gastroesophageal reflux disease (GERD) is the main predisposing factor for the appearance of BE, due to the constant aggressions to which the esophageal mucosa epithelium is submitted. It is important to emphasize that patients with BE have an 11-fold higher relative risk of developing adenocarcinoma compared to the general population, which occurs as a result of a metaplasia-dysplasia-carcinoma sequence. Also in this sense, BE reaches approximately 3 million people in Brazil and there has been a significant increase in its number of years in recent years.In order to follow up and observe this disease in the population, it is extremely important to identify epidemiological factors associated with this pathology. Therefore, this study seeks to recognize conditions associated with a higher incidence of evolution of BE dysplasia and/or esophageal adenocarcinoma, based on a sample of patients with BE who are followed up at HCFMUSPFrom the collection of data from patients with BE at HCFMUSP, we intend to identify and compare the follow-up carried out in the service with the international guidelines for surveillance of Barrett's esophagus, in order to carry out a critical analysis of the cost-effectiveness of this follow-up in a national scene. Thus, the objective is to develop procedures that reduce the demand overload of esophagogastroduodenoscopy in the public service, reduce waiting lines for endoscopic exams and at the same time perform an early identification of possible evolutions in dysplasia and cancer in an optimized way.