Since obesity is a risk factor for esophageal cancer, and this disease usually begins as Barrett’s esophagus, should all obese people get an annual screening for this precancerous condition?

Esophageal cancer has a poor prognosis because by the time it’s finally diagnosed, it has usually spread beyond the GI tract.

In addition to obesity, risk factors include smoking, drinking and chronic gastroesophageal reflux disease (GERD).

Esophageal cancer typically arises from Barrett’s esophagus – a condition in which the cells of the inner esophagus have changed over time, becoming precancerous.

The Upper Endoscopy

“Screening upper GI endoscopy is recommended for persons who have chronic reflux symptoms and other risk factors such as obesity, age over 50 years, male gender and Caucasian ethnicity,” says Santosh Sanagapalli, MD, a consultant gastroenterologist, endoscopist and specialist in esophageal disorders.

“So, for example, an obese person over the age of 50 who suffers with reflux symptoms should have a one-off endoscopy to check for the presence of Barrett’s esophagus.

“If the endoscopy is normal, however, then further screening endoscopies are not required on an annual basis, as the risk of subsequently developing Barrett’s after a completely normal endoscopy is extremely low.”

However, this doesn’t mean you should never ever again undergo an upper endoscopy if you begin developing new symptoms that are suggestive of a GI tract disorder.

Never ignore new, unexplained symptoms that don’t respond to over-the-counter antacids or other medications or that are persistent or worsening.

These symptoms include difficulty getting food down, food or beverages that come back up soon after swallowing, pain during or soon after swallowing, unintentional weight loss, a stuck food feeling in the chest, upchucking blood, and having to switch to soft foods because harder or denser foods such as meat, bread and apples won’t go down.

An upper endoscopy is the gold standard for finding out what can be causing these issues.

Dr. Sanagapalli is a gastroenterologist and director of the Esophageal Disorders Center at St Vincent’s Hospital, Darlinghurst. He performs diagnostic and therapeutic endoscopic procedures, and enjoys providing comprehensive and holistic care to patients with a wide variety of disorders affecting the gastrointestinal tract.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.



Top image: Vadimguzhva/Getty Images