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Abstract

Background: Firefighters have frequent exposure to smoke and compounds shown to increase the risk of esophageal neoplasia. However, many are unaware of their risk for Esophageal Adenocarcinoma (EAC) or the precursor condition Barrett's Esophagus (BE), and screening endoscopy can be difficult to accommodate with shift schedules. The EsoGuard^®/EsoCheck^® (EG/EC) solution includes a biomarker assay (EsoGuard^®/EG) and a non-endoscopic esophageal cell collection device (EsoCheck^®/EC), which can be utilized with efficiency and high tolerability as a triage test for BE/EAC.
Methods: This is a retrospective analysis of prospectively collected data on use of the EG/EC solution during two large health fairs for on-duty firefighters in San Antonio, TX, in January 2023.
Results: Firefighters were evaluated by physician volunteers; among those deemed at high risk for BE/EAC, 388 firefighters agreed to EG/EC testing. Over 99% (385/388) successfully provided EC cell samples for analysis, and the EG positivity rate was 7.27% (28/385). Among those who tested EG positive, 100% (28/28) were referred by the ordering physician for confirmatory upper endoscopy. No EG negative subjects were referred for additional testing.
Conclusion: In this initial experience, EG/EC proved to be a rapid, efficient, and well-tolerated test to triage on-duty firefighters at high risk of BE/EAC to endoscopy; EG results demonstrated strong physician decision impact.