Clinical Utility of EsoGuard® as an Efficient Triage Test for Diagnosing Barrett’s Esophagus in On-Duty Firefighters

Abstract

BackgroundFirefighters have frequent exposure to smoke and compounds that have been shown to increase the risk of developing esophageal neoplasia. EsoGuard® is a DNA biomarker assay that can be utilized with efficiency and high tolerability as a triage test in the diagnosis of patients with Barrett’s Esophagus (BE) and/or esophageal adenocarcinoma (EAC) in this population.MethodsThis is a retrospective analysis of prospectively collected clinical utility data on use of EsoGuard® DNA testing on samples collected with the nonendoscopic esophageal cell collection device, EsoCheck®, during two large cancer screening events for firefighters in San Antonio, TX, in January 2023.ResultsA total of 388 firefighters volunteered for screening of Barrett’s Esophagus and esophageal adenocarcinoma, of which 385 (>99%) successfully provided cell samples for EsoGuard analysis. There was a 7.27% (28/385) positivity rate, which was similar among males and females (7.26% and 7.41%, respectively). Only 13/385 (3.37%) tests failed analysis due to insufficient DNA sampling. Among those who tested positive with EsoGuard, 100% (28/28) were referred by the ordering physician for gastroenterology and upper endoscopy evaluation. Among those who tested negative, none were referred for upper endoscopy evaluation. This resulted in a 100% concordance between EsoGuard results and physician management decisions.ConclusionsThis study capturing real-world data on the use of EsoGuard for early detection of BE/EAC in firefighters demonstrates the ability of this diagnostic tool to efficiently screen high-risk populations in a manner that is well tolerated, has high result yield, and effectively drives physician management decisions.