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Joint Awareness Campaign ("Action Against Heartburn")

In last years's E-bulletin 1 we highlighted the need to raise awareness of Barrett's oesophagus and we are now pleased to report that we have played a significant part in developing and supporting a Joint Awareness Campaign on behalf of:

The Association of Upper GI Surgeons (AUGIS), Barrett's Oesophagus Campaign (BOC), Cancer Research UK (CRUK), Goddfund, OCHRE, Campaign Against Reflux Disease, National OesophagoGastric Cancer Awareness, and Oesophageal Patients Association (OPA).

Key messages of the Awareness Campaign include:

  • Consult your GP if you have persistent (every day) heartburn, indigestion, persistent hiccups or food regurgitation, difficulty or pain on swallowing food, unexplained weight loss.
  • Do not keep taking over-the-counter indigestion remedies week after week without seeing your GP for further investigations.

We have attended 4 joint meetings in London during 2011 and developed a document "The need for greater awareness of the symptoms of oesophageal and gastric cancer" ( 21 July 2011, amended 27 November 2011) with the aim of developing key messages targeting GP's, Pharmacies and the general public. The joint meetings have been ably chaired by Alan Moss (London Support Group Co-ordinator for OPA).

We have submitted our messages to a medical panel who have commended the document as a best effort to reflect the current understanding of the medical issues, particularly the links between acid reflux (heartburn) Barrett's oesophagus and oesophageal adenocarcinoma.

Medical Panel:

  • William H Allum MB ChB MD FRCS, Consultant Upper GI surgeon, Royal Marsden Hospital, Sutton, Surrey
  • Piers AC Gatenby MA MD FRCS, Department of Surgery, Royal Marsden Hospital, London
  • Professor S Michael Griffin MD FRCS, Professor of Gastrointestinal Surgery, Northern Oesophago-gastric Unit, Royal Victoria Hospital, Newcastle upon Tyne
  • Dr Jonathon Hoare MA PhD FRCP, Consultant Gastroenterologist, St Mary's NHS Trust and Imperial College School of Medicine
  • Dr Charles DR Murray MD FRCP, Consultant Gastroenterologist, Royal Free Hospital, London
  • Professor Liam Murray MD MFPHM MRCGP, Clinical Professor (Cons), School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Royal Victoria Hospital, Belfast
  • Dr Praful Patel MD FRCP, Consultant Physician & Gastroenterologist and Honorary Senior Lecturer, Southampton University Hospitals NHS Trust

Professor Anthony Watson, Trustee of BOC and Executive Director of UKBOR, has been appointed Senior Medical Adviser to the Joint Awareness Campaign. A number of members of the joint group, including Dr Paul Salmon (Chair of BOC) and Dr Christine Caygill (Registrar to UKBOR) from BOC were invited by Professor Sir Mike Richards (National Cancer Director) to join his Expert Panel on Oesophago-gastric cancer, convened and chaired by him on 8th September 2011. Following this meeting the Department of Health allocated substantial resources (£750,000) to launch pilot studies in 7 UK regions in January-March 2012 in order to establish the importance and understanding of the key messages relating to the early diagnosis of oesophago-gastric cancer with some emphasis on heartburn.

The development of key messages continues and the current debate is active with our Joint awareness group and other groups and individuals pressing for greater awareness of Barrett's oesophagus, including abolition of the current 55 age limit suggested by the DOH below which those with heartburn/indigestion/swallowing difficulties would not be targeted. Emphasis on earlier diagnosis of Barrett's as an important goal in reducing deaths from oesophageal cancer (especially adenocarcinoma the most common and rapidly increasing form) remains one of our key aims, especially as data from UKBOR shows that 27% of cases of Barrett's at diagnosis are < 55 yrs of age and 12% of cases of adenocarcinoma of the oesophagus (gullet) are under the age of 55 at diagnosis. There are others who are fearful of their endoscopy clinics being overwhelmed with a possible delay in diagnosis of those who are developing oesophageal cancer. We do not believe that this will happen. The debate continues.

At the present time it is planned that the joint awareness group will continue a parallel campaign with the Department of Health initiative until the precise plans for the DOH campaign become established.

We are also developing plans and resources to produce a BMJ learning module which is an online learning and testing module for healthcare professionals who can then receive an up to date detailed account of Barrett's oesophagus. This module when completed will form part of the Joint Awareness Campaign. We have already opened a new website www.actionagainstheartburn.org.uk which can provide more information concerning this campaign.

During 2011 BOC was registered as a Stakeholder for NICE (National Institute of Clinical Excellence) in their Dyspepsia panel and their Early Diagnosis of Cancer panel. Paul Salmon will be attending the dyspepsia NICE meeting in Manchester in February 2012.

Alex Rose, a sixth form student in Harpenden has completed a Nuffield Bursary studying the progression of Barrett's oesophagus to adenocarcinoma. He has made it to the finals of the National Science Competition which will be held at the Big Bang Science Fair at the NEC in March 2012. Alex has approached BOC and we are collaborating with him to assist his excellent initiative. All of us at BOC wish Alex the best of luck and congratulate him on this initiative


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