OBJECTIVE: Review the rationale behind secondary prevention of Barrett’s related esophageal adenocarcinoma and critically appraise the emerging literature regarding prevention of neoplasia in Barrett’s esophagus with antisecretory and/or cyclo-oxygenase inhibition therapy. METHODS: The existing English language literature regarding secondary cancer prevention in patients with Barrett’s esophagus is reviewed and its potential clinical implications discussed. RESULTS: There is biologic plausibility to pursue “chemo-prevention” trials with antisecretory and/or cyclo-oxygenase inhibition therapy in patients with Barrett’s esophagus. CONCLUSION: Chemoprevention trials using potent antisecretory therapy coupled with cyclo-oxygenase 2 inhibition are warranted and may provide a means of decreasing the occurrence of cancer and cancer-related mortality in this disease.
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