Australian guidelines on Barrett’s Oesophagus and Oesophageal Adenocarcinoma

Cancer Council Australia has published new clinical guidelines which will help provide greater consistency in the management one of Australia’s fastest growing cancers and its known precursor, Barrett’s oesophagus.
The new clinical guidelines for the “management and diagnosis of Barrett’s Oesophagus and oesophageal adenocarcinoma”are the first of their kind in Australia and are now available on Cancer Council Australia’s cancer guidelines wiki.
Cancer Council Australia led the development of the guidelines with Professor David Whiteman chairing the multidisciplinary working party. Professor Whiteman highlights that to provide clear guidelines for doctors, it was important to address oesophageal adenocarcinoma (OAC) and Barrett’s Oesophagus together.
“The incidence of oesophageal cancer is increasing and we also know that Barrett’s is being diagnosed more frequently,” Professor Whiteman said.
“Despite their greatly increased relative risk of cancer, 95% of people with Barrett’s never develop OAC and 95% of patients diagnosed with OAC have no preceding diagnosis of Barrett’s Oesophagus. "Up until now there has been clinical uncertainty about the best way to manage Barrett’s, both at the individual level and across the population, particularly in the Australian healthcare context.”
Professor Whiteman said that addressing the prevention and management of both diseases was particularly important given the low survival rates once cancer had developed.
“Survival from advanced OAC is very poor, hence the focus on diagnosing and treating people with precancerous and early cancerous lesions,” he said.
“Previously Australian doctors had to look to international guidelines for advice on how to manage their patients, which may not always apply to our health system. We have systematically reviewed the published evidence to develop recommendations for Australian doctors and patients.
“Simply put, the new guidelines provide helpful advice to identify those patients who need close management, from those who can be reassured.
“Clinicians may also be interested to see our recommendations around endoscopy for high-grade Barrett’s lesions, which were previously treated with more invasive surgery. We have also outlined recommendations for patient advice.”