Henrico Firefighter Esophageal Pre-Cancer Screening

I hereby release the screening physician, Hampton Roads Ultrasound and all other healthcare volunteers from all responsibility in connection with this screening exam. I understand that I will only be screened for risk factors or symptoms of cardiovascular disease and cancer and that this screening does not constitute a complete medical exam or diagnosis, and that I do not have a physician-patient relationship with the screening physician by virtue of this screening exam. I further understand that I will receive a copy of my screening results. I may receive a follow-up phone call from a licensed medical provider. It is solely my responsibility to seek any appropriate follow-up medical treatment as indicated by my screening results. No one may use my examination results for any purpose, other than statistical study as long as no identifying information is published. I consent to ultrasound testing performed by Hampton Roads Ultrasound. I have read and understand this form and understand the information presented.

 

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Exam Descriptions

 WHO:

EsoGuard is not a population screening test. The American Gastroenterological Association has defined 7 risk factors to qualify for screening and there is an additional 8th risk factor specific to occupational exposure to firefighters that has been established and substantiated by published NIOSH data. Please see the attached Risk Factor Questionnaire to distribute to your department to see if they meet screening criteria. The qualify for screening, you only need to hit any 3 out of the 8 risk factors:

- Male gender
- Caucasian race
- Age 50+
- Heartburn/Reflux/GERD
- Obesity, BMI 30+
- Smoking, past or present history
- Family history of BE or EAC
- Firefigher, occupational exposure – 10+ years (volunteer or career)

**No food or liquid for 2 hours prior to test**

WHY SHOULD FIREFIGHTERS GET SCREENED:

Esophageal Adenocarcinoma (EAC) is the fastest growing cancer in the United States with a 733% increase in incidence in the past 40 years. EAC is the 7th leading cause of cancer death in men. It is a highly lethal cancer; the average time from diagnosis to death is ~13 months and the 5-year survival rate is only ~20%...but it can be prevented through screening.

Firefighters have a 62% greater risk of developing Esophageal Adenocarcinoma (EAC) and a 39% higher likelihood or dying from EAC. This is substantiated in multiple clinical papers and frequently referenced by the Firefighter Cancer Support Network. The Firefighter Cancer Support Network states that firefighters have an 80% greater likelihood of developing EAC than non-firefighters.

There is nothing “nice” about cancer, however the “nice” thing about EAC is that it has an established, diagnosable pre-cancerous condition called Barrett’s Esophagus (BE). EsoGuard can identify BE with a high degree of sensitivity and specificity, starting with methylation changes that occur during the earliest cellular changes all the way through to EAC. The goal is to find pre-cancer and effectively treat it with ablation therapies so that it never turns into cancer. EsoGuard provides a binary “yes or no” result, and patients with a positive result should go on for confirmatory upper endoscopy.

EsoGuard is NOT an annual screening, it is better to be screened one time than never at all. If a firefighter’s risk factor profile changes in the 5-10 years after an initial negative screening result, a repeat screening is recommended. If someone over the age of 60 receives a negative screening result, there is no reason for that individual to be screened again.

 

Screening Location:

908 E. Nine Mile Rd

Highland Springs, VA

23075

I certify that all the information provided is accurate to the best of my ability and I consent to the cardiovascular and/or early detection cancer screening examinations.