What is the relationship between Eosinophilic Esophagitis (EE) and esophageal cancer?

From the Guidelines

Eosinophilic Esophagitis (EE) has not been associated with the development of esophageal malignancy. The current evidence suggests that EE is a chronic immune-mediated condition characterized by eosinophilic infiltration of the esophageal mucosa, leading to symptoms such as dysphagia, food impaction, and chest pain. According to a systematic review and consensus recommendations for diagnosis and treatment published in Gastroenterology in 2007 1, the main aim of monitoring EE patients is to prevent progressive esophageal dysfunction and detect complications from therapy, rather than to screen for esophageal cancer.

Key Points to Consider

• EE has not been linked to an increased risk of esophageal cancer, as stated in the study 1
• The primary goal of monitoring EE patients is to manage the condition itself, rather than to screen for cancer
• Regular endoscopic monitoring is recommended for EE patients to assess disease activity and structural changes, typically every 1-3 years depending on symptom control
• Untreated EE can lead to esophageal remodeling and strictures, which may cause complications, but this is not directly related to an increased risk of esophageal cancer

Management of EE

The standard treatment for EE includes proton pump inhibitors, topical steroids, and dietary modifications. For severe cases, systemic steroids may be used. Regular monitoring and treatment of EE are crucial to prevent complications and improve quality of life, but this is not driven by a concern for esophageal cancer development, as evidenced by the study 1.

From the Research

Relationship between Eosinophilic Esophagitis (EE) and Esophageal Cancer

There is no direct evidence in the provided studies that discusses the relationship between Eosinophilic Esophagitis (EE) and esophageal cancer.

Treatment Options for Eosinophilic Esophagitis

• The current treatment options for EE include:
  • Dietary modifications, such as a 6-food elimination diet 2, 3
  • Medical therapy, including swallowed topical corticosteroids and proton pump inhibitors 4, 5, 2, 3, 6
  • Endoscopic dilation for esophageal strictures 2, 3, 6
• Emerging therapies, such as monoclonal antibodies, are being investigated for the treatment of EE 6

Diagnosis and Pathophysiology of Eosinophilic Esophagitis

• EE is a chronic inflammatory disorder characterized by symptoms of esophageal dysfunction and eosinophil-predominant inflammation 4
• The diagnosis of EE requires a combination of clinical symptoms and histologic findings, including at least 15 eosinophils per high-power field 5, 2, 3
• The pathophysiology of EE is complex and involves a combination of genetic and environmental factors 3