Barrett's-related esophageal adenocarcinoma: Is chemoprevention a potential option?

OBJECTIVE: Review the rationale behind secondary prevention of Barrett's re lated esophageal adenocarcinoma and critically appraise the emerging litera ture regarding prevention of neoplasia in Barrett's esophagus with antisecr etory and/or cyclo-oxygenase inhibition therapy. METHODS: The existing English language literature regarding secondary cance r prevention in patients with Barrett's esophagus is reviewed and its poten tial clinical implications discussed. RESULTS: There is biologic plausibility to pursue "chemoprevention" trials with antisecretory and/or cyclo-oxygenase inhibition therapy in patients wi th Barrett's esophagus. CONCLUSION: Chemoprevention trials using potent antisecretory therapy coupl ed with cyclo-oxygenase 2 inhibition are warranted and may provide a means of decreasing the occurrence of cancer and cancer-related mortality in this disease. (C) 2001 by Am. Coll. of Gastroenterology.