[Gastroesophageal reflux disease and malignancy]

Severe gastroesophageal reflux disease (GERD) predisposes to the development of Barrett's esophagus defined by the replacement of the squamous epithelium of the distal esophagus by a columnar epithelium. Barrett's esophagus is a precancerous condition which has a risk of malignant transformation to adenocarcinoma. Barrett's adenocarcinoma remains a relatively rare condition. Its incidence among patients followed up for Barrett's esophagus is approximately 0.5% patients per year. Besides GERD, obesity, male gender and age are the main risk factors for the development of Barrett's mucosa and esophageal adenocarcinoma. Men above 50 presenting with ancient and frequent GERD symptoms could benefit from an upper-GI endoscopy to detect Barrett's esophagus. Though still controversial, surveillance of Barrett's mucosa could allow detection of high grade dysplasia and esophageal adenocarcinoma at an early stage, enabling a curative treatment. Patients who cannot undergo surgery may be treated using endoscopic techniques such as endoscopic mucosal resection.