New treatment guidelines for Barrett’s esophagus: UNC played key role

Tom Hughes wrote this …

On March 1, the American Gastroenterological Association (AGA) Institute announced a new position statement on how patients with a high-risk form of Barrett’s esophagus should be treated. The bottom line of that statement? It says that using any of three treatment methods to remove pre-cancerous cells from inside the throats of these patients is now the preferred course of action instead of “watchful waiting,” which is what was previously recommended.

The title page of Dr. Shaheen's NEJM article on RFA for Barrett's esophagus.

Curiously, this important development has gotten very little media coverage to date. I say this is curious because in 2008 and 2009, the media treated the results of a nationwide clinical trial of radiofrequency ablation (RFA) for Barrett’s esophagus, one of the three now-preferred treatments, as very big news indeed. For example, coverage in May 2008 — when Dr. Nicholas Shaheen of UNC presented results of the trial at the Digestive Disease Week conference in San Diego — included stories in the Wall Street Journal and the CBS Evening News. This clinical trial received additional national media coverage one year later, when an article by Dr. Shaheen reporting the results was published in the New England Journal of Medicine.

Here’s a video our office produced with Dr. Shaheen about the NEJM study:

Why do I call your attention to this now? Two reasons. First, Dr. Shaheen was a senior author of the new AGA position statement on management of Barrett’s esophagus. And second, April is Esophageal Cancer Awareness Month — and the greatest risk faced by Barrett’s patients is the fact that some of them go on to develop esophageal cancer, which is one of the deadliest forms of cancer.

Of course, Dr. Shaheen did not do this work alone. There were participating investigators at 19 other sites across the U.S. Others involved here at UNC included Dr. Evan Dellon, Dr. Ryan Madanick and Dr. Tara Rubinas, who all contributed to the video below, which was posted on the NEJM website and on YouTube. (The narrator you hear in the video is Dr. Dellon.)

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