FRANK A. LEDERLE, M.D.
To the editor: In a recent editorial (1), Dr. Spechler advocated endoscopic surveillance for patients with Barrett esophagus to prevent esophageal cancer. Several aspects of his analysis deserve further scrutiny. First, Dr. Spechler argues that the risk of cancer in these patients is sufficient to warrant surveillance because it is higher than the risk in a region of China where mass screening has been implemented. However, no justification is given for the Chinese policy. In fact, this program appears to have had little effect on mortality (2). Second, Dr. Spechler cites the incidence of esophageal cancer in patients with Barrett
LEDERLE FA. Endoscopic Surveillance of Patients with Barrett Esophagus. Ann Intern Med. ;107:592–593. doi: 10.7326/0003-4819-107-4-592_2
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Published: Ann Intern Med. 1987;107(4):592-593.
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