Evaluating Barrett’s and Dysplasia incidence and treatment trends across the island of Ireland

Dr. Veronica Child

Dr. Veronica Child was awarded with a post-doctoral fellowship as part of All-Ireland Cancer Research Network funded by Breakthrough Cancer Research. Veronica is working in Prof. Helen Coleman’s lab at Queen’s University Belfast.

Barrett’s oesophagus is a premalignant condition which offers opportunities for early detection, diagnosis and treatment of dysplasia (characterised by abnormal (but not yet malignant) cell growth and development) and oesophageal cancer as following a Barrett’s oesophagus diagnosis, patients are followed up to monitor further changes in the oesophagus.

Our population-based and multi-centre research on the island of Ireland has shown that the majority patients living with Barrett’s oesophagus did not progress to dysplasia or cancer but risk of progression is not uniform across all patients. Work is ongoing to identify groups of Barrett’s oesophagus patients at lower or higher risk of progression to reduce healthcare burden and provide reassurance for low-risk patients whilst ensuring that patients at higher risk are followed-up more frequently. For those who do progress, there are now novel treatments available via the flexible tube used for endoscopy (camera test) making them less invasive than previous treatment options. The impact of endoscopic treatment receipt for Barrett’s dysplasia patients across the island of Ireland, particularly after the COVID-19 pandemic, has not yet been quantified. This work aims to bring together two unique large-scale Barrett’s registry data sources to: (i) explore trends in the number and characteristics of people being diagnosed with Barrett’s oesophagus and dysplasia across the island of Ireland; (ii) compare endoscopic treatment access and outcomes between the different healthcare structures in the North and South.

The findings will inform future service planning and the development of clinical guidelines for the management of Barrett’s oesophagus such as through identifying groups of patients at higher risk of progression. Evidence-based patient information resources will be co-designed with our patient representatives, to communicate current Barrett’s oesophagus research results in an easily accessible format.