Previous research has established that despite the low risk from their condition, patients with Barrett’s esophagus (BE) often have higher levels of concern about cancer, which in turn has a negative impact on their overall health-related quality of life (HRQoL).
In a paper published in BMJ Open Gastroenterology, researchers conducted a multicenter cohort study to compare dysplastic BE patients’ HRQoL preendoscopic therapy (pre-ET) and post-ET. The pre-ET BE group was also compared with other cohorts: nondysplastic BE (NDBE), colonic polyps, gastroesophageal reflux disease (GERD), and healthy volunteers.
Participants in the pre-ET cohort were recruited prior to their ET, and HRQoL questionnaires were provided pre-ET and post-ET. The researchers used the Wilcoxon rank test to compare the pre-ET and post-ET findings. Multiple linear regression analysis was used to compare the pre-ET group’s HRQoL results with the other cohorts’ HRQoL results.
Sixty-nine participants in the pre-ET group returned the questionnaires prior to ET and 42 returned them post ET. Both the pre-ET and post-ET groups exhibited comparable levels of concern about cancer despite the treatment, and the results from the Short Form-36 (SF-36) Score revealed no statistical significance with regard to symptom scores, anxiety, depression, or general health measures.
The pre-ET group was compared with the NDBE group (n = 379), gastroesophageal reflux disease (GERD) patients (n = 132), colonic polyp patients (n = 152), and healthy volunteers (n = 48). Overall, more education was needed among the BE patients, with many of the pre-ET group still reporting unanswered questions about their disease. Moreover, despite their lower risk of progression, concerns about cancer were comparable between the NDBE group and the pre-ET group. From a reflux and heartburn perspective, GERD patients had worse symptom scores. Significantly better scores on the SF-36 and improved hospital anxiety and depression scores were noted only in the healthy group.
“This large multicentre comparative cohort study shows patients undergoing treatment for dysplasia and early cancer had similar rates of concerns about cancer pre- and post-endoscopic treatment. Patients with Barrett’s reported ongoing unanswered questions about their disease even when treated, and satisfaction with follow-up services was mixed,” the authors wrote.
The authors continued, “These findings suggest that there is a need to improve HRQoL for patients with BE. This should include improved education and devising-specific patient-reported outcome measures for BE to capture relevant areas of HRQoL in future studies.”
The researchers also concluded that their findings demonstrate elevated burdens of concern about cancer among all stages of BE and the need for improved education, reassurance, and follow-up care in this patient population.
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