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Invited Commentary
March 2014

Endoscopy in Symptomatic Gastroesophageal Reflux DiseaseScoping Out Whom to Target

Author Affiliations
  • 1University of Newcastle, Newcastle, New South Wales, Australia
  • 2John Hunter Hospital, Newcastle, New South Wales, Australia
  • 3Mayo Clinic, Rochester, Minnesota
JAMA Intern Med. 2014;174(3):465-466. doi:10.1001/jamainternmed.2013.12992

Heartburn from gastroesophageal reflux disease (GERD) affects up to 20% of the US population, accounting for more than 4 590 000 outpatient visits and 96 000 hospitalizations annually at an estimated cost of $9.3 billion per year.1 In 2009, there were an estimated 6.9 million esophagogastroduodenoscopies (EGDs) performed in the United States.2 An EGD is usually the first test a clinician considers to rule out complications of chronic GERD and plan management. These complications range from benign stricture formation and esophagitis to the more feared premalignant condition Barrett esophagus (BE). Biopsy-proven BE has been shown to increase the risk of esophageal adenocarcinoma approximately 30 times, but the absolute background risk is low (annual cancer incidence is approximately 0.5% per year).3

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