Worry for cancer in association with gastro-esophageal reflux symptoms in patients endoscopically treated for Barrett’s neoplasia. A cross-sectional questionnaire study

Abstract

Background Endoscopic treatment has become the preferred treatment for (early) neoplasia in a Barrett Esophagus (BE). The diagnoses and treatment of this pre-malignant condition may trigger cancer worry. Reflux symptoms are known as an important factor for negative illness perception on BE. The aim of this study was to assess worry for cancer and reflux symptoms in patients endoscopically treated for a BE (DBE) compared to non-dysplastic BE (NDBE) patients and to patients with reflux symptoms only. Methods We performed a cross sectional self-administered questionnaire study using the cancer worry scale, and reflux disease questionnaire. Results From October 2019 until July 2021, 192 DBE patients, 213 NDBE patients and 111 refractory reflux symptom patients were included, 76.8% of participants were male and aged 66.9 years. High cancer worry was reported in 40.6% of the DBE patients and 36.2% of NDBE patient. Reflux patients scored significant worse with 56.6% stated high cancer worry. Positive correlations were found between reflux symptoms and cancer worry in NDBE patients (R=.326; p=<.000 N 213) and reflux patients (R=.233; p= .019 N=11)1. In DBE patients correlations were found on higher cancer worry and younger age (R=.-190; p=.009 N 187) and a (family) history of diagnosis of esophageal carcinoma (R= .192; p=0.08 N187). Conclusions BE patients reported low cancer worry and good reflux symptom control. Still a significant group of DBE patients reported high cancer worry. Physicians should communicate about the actual cancer risk, which leads to greater patient understanding and may therefore positively affects health outcomes.