Date of Award

2022

Document Type

Open Access Thesis

Degree Name

MS in Physician Assistant Studies (PA)

Department

Physician Assistant Studies

First Advisor

Eric Van Hecke, MPAS, PA-C, CAQ-EM, DMSC candidate

Abstract

Background: Barrett’s esophagus is the most significant predictor of the development of esophageal adenocarcinoma. The current treatment recommendation is a proton pump inhibitor to control acid reflux, yet there remains a significant number of individuals who progress to cancer. More can be done to prevent this progression.

Purpose: To this end, this paper seeks to answer the following PICO question: P: Patients with Barrett’s esophagus not yet esophageal adenocarcinoma; I: Standard PPI treatment with the addition of Aspirin; C: Standard PPI treatment only; O: Prevention of progression of Barrett’s esophagus to esophageal adenocarcinoma.

Methods: A comprehensive literature review was conducted using PubMed, Sage Journals, and Science Direct using the search terms Barrett’s esophagus treatment, Barrett’s esophagus aspirin, esophageal cancer prevention aspirin, cancer prevention aspirin, and prostaglandin cancer. Inclusion criteria were peer-reviewed, scholarly journals and studies published during or after 2017. Excluded from the search were meta-analyses and reviews.

Conclusions: Aspirin shows promise as a possible adjunctive treatment to proton pump inhibitors. A long-term study is needed to specifically assess if adding aspirin will reduce progression to adenocarcinoma while also assessing safety. Several biomarkers and tissue pathologies are already available to risk stratify who could benefit from this add-on treatment.

Identifier

SC 11.PAS.2022.Speakman.J

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