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Virtually all EACs develop from the precursor lesion Barrett\u2019s esophagus (BE), which is the most significant risk factor for EAC. However, the rates of progression from BE to EAC are low and patients with BE are asymptomatic. Thus, any strategy for EAC prevention must carry a low risk of harm in order to be clinically useful. Since current EAC-screening and BE-surveillance methods carry some procedural risk and are burdensome, there is an opportunity for chemoprevention, i.e. medications or dietary factors that may prevent BE from progressing to EAC. A variety of candidate chemoprevention therapies have been assessed to date. Proton-pump inhibitors (PPIs) are the best studied and have modest EAC-chemoprevention efficacy in BE patients, with a recent randomized trial showing that high-dose PPI may be more effective than low-dose PPI. Aspirin and other non-steroidal anti-inflammatory drugs have moderate quality observational and randomized-trial evidence for preventing progression of BE to EAC, but their risks for harm have precluded their routine clinical use. Other therapies (statins, metformin, female sex hormones) generally do not have strong evidence to support their use in EAC chemoprevention. Although progress has been made in this field, there is still a need for more effective and safe chemoprevention therapies for EAC.<\/jats:p>","DOI":"10.1093\/gastro\/goaa040","type":"journal-article","created":{"date-parts":[[2020,6,2]],"date-time":"2020-06-02T03:33:52Z","timestamp":1591068832000},"page":"253-260","source":"Crossref","is-referenced-by-count":13,"title":["Chemoprevention of esophageal adenocarcinoma"],"prefix":"10.1093","volume":"8","author":[{"given":"Erik J","family":"Snider","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, University of Washington School of Medicine, Seattle, WA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew M","family":"Kaz","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, University of Washington School of Medicine, Seattle, WA, USA"},{"name":"Gastroenterology Section, VA Puget Sound Health Care System, Seattle, WA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John M","family":"Inadomi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, University of Washington School of Medicine, Seattle, WA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William M","family":"Grady","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, University of Washington School of Medicine, Seattle, WA, USA"},{"name":"Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,7,24]]},"reference":[{"key":"2020122411293080300_goaa040-B1","doi-asserted-by":"crossref","first-page":"2499","DOI":"10.1056\/NEJMra1314530","article-title":"Esophageal 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