Identifying Patients at Risk for Esophageal Cancer: Impact of a Nurse Practitioner Wellness Center Assessment

2.50
Hdl Handle:
http://hdl.handle.net/10755/165754
Category:
Abstract
Type:
Presentation
Title:
Identifying Patients at Risk for Esophageal Cancer: Impact of a Nurse Practitioner Wellness Center Assessment
Author(s):
Milazzo, Carol
Author Details:
Carol Milazzo, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
Abstract:
Background: This year, 13,200 people will be diagnosed with esophageal cancer. The incidence of adenocarcinoma of the esophagus among men has increased more than 100% in recent decades. Gastroesophageal reflux disease (GERD) is a risk factor and affects up to 40% of the adult population. The symptoms of reflux considered specific for GERD are heartburn and acid regurgitation. Barrett's esophagus is a precancerous condition where the cellular lining of the esophagus is damaged by chronic reflux of gastric contents from the stomach into the esophagus. Barrett's can be found in 10%-13% of patients with chronic GERD. Barrett's is associated with a 30-52-fold increase in the occurrence of esophageal carcinoma. There are currently no screening recommendations for esophageal cancer. The Prevention and Wellness Center at this NCI-designated comprehensive cancer center identifies individuals at increased risk by assessing for early signs and symptoms of esophageal disease. Methods: To identify individuals who may be at increased risk for esophageal cancer, patients were asked three screening questions by the nurse practitioner: 1) Have you ever been diagnosed with Barrett's esophagus? 2) Do you have any difficulty swallowing? and 3) Do you have chronic heartburn? Patients with a positive response to one or more of these questions were clinically assessed by the nurse practitioner and collaboratively reviewed with a member of the gastroenterology team. A determination for upper endoscopy screening was then made. Results: From June 2000 until June 2001, 461 patients were asked the three screening questions. A total of 75 patients answered positively to at least one question. Findings are as follows: 33 normal upper endoscopies, eight Barrett's esophagus, 10 esophagitis, seven did not follow through with scheduled screening, eight were deemed inappropriate after clinical assessment/collaborative review, and nine patients are awaiting screening. Conclusions: The rising incidence of esophageal cancer warrants attention. As a result of our findings, our nurse practitioners incorporate assessment for esophageal disease into their practice. Despite the lack of screening recommendations for esophageal cancer, the inclusion of three simple questions as part of a routine physical assessment may identify patients at increased risk who would benefit from individualized screening recommendations.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2002
Conference Name:
27th Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
Washington, D.C., USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleIdentifying Patients at Risk for Esophageal Cancer: Impact of a Nurse Practitioner Wellness Center Assessmenten_GB
dc.contributor.authorMilazzo, Carolen_US
dc.author.detailsCarol Milazzo, Memorial Sloan-Kettering Cancer Center, New York, New York, USAen_US
dc.identifier.urihttp://hdl.handle.net/10755/165754-
dc.description.abstractBackground: This year, 13,200 people will be diagnosed with esophageal cancer. The incidence of adenocarcinoma of the esophagus among men has increased more than 100% in recent decades. Gastroesophageal reflux disease (GERD) is a risk factor and affects up to 40% of the adult population. The symptoms of reflux considered specific for GERD are heartburn and acid regurgitation. Barrett's esophagus is a precancerous condition where the cellular lining of the esophagus is damaged by chronic reflux of gastric contents from the stomach into the esophagus. Barrett's can be found in 10%-13% of patients with chronic GERD. Barrett's is associated with a 30-52-fold increase in the occurrence of esophageal carcinoma. There are currently no screening recommendations for esophageal cancer. The Prevention and Wellness Center at this NCI-designated comprehensive cancer center identifies individuals at increased risk by assessing for early signs and symptoms of esophageal disease. Methods: To identify individuals who may be at increased risk for esophageal cancer, patients were asked three screening questions by the nurse practitioner: 1) Have you ever been diagnosed with Barrett's esophagus? 2) Do you have any difficulty swallowing? and 3) Do you have chronic heartburn? Patients with a positive response to one or more of these questions were clinically assessed by the nurse practitioner and collaboratively reviewed with a member of the gastroenterology team. A determination for upper endoscopy screening was then made. Results: From June 2000 until June 2001, 461 patients were asked the three screening questions. A total of 75 patients answered positively to at least one question. Findings are as follows: 33 normal upper endoscopies, eight Barrett's esophagus, 10 esophagitis, seven did not follow through with scheduled screening, eight were deemed inappropriate after clinical assessment/collaborative review, and nine patients are awaiting screening. Conclusions: The rising incidence of esophageal cancer warrants attention. As a result of our findings, our nurse practitioners incorporate assessment for esophageal disease into their practice. Despite the lack of screening recommendations for esophageal cancer, the inclusion of three simple questions as part of a routine physical assessment may identify patients at increased risk who would benefit from individualized screening recommendations.en_GB
dc.date.available2011-10-27T12:24:18Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:24:18Z-
dc.conference.date2002en_US
dc.conference.name27th Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationWashington, D.C., USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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