Kenneth J. Chang, M.D., and Hoag Memorial Hospital Presbyterian are on a mission to make esophageal cancer a thing of the past.
“Digestive cancers, especially esophageal cancer, are among the deadliest, yet gastrointestinal esophageal reflux disease (GERD) is a common, treatable precursor,” Dr. Chang said. “This makes esophageal cancer highly preventable. With the right strategy and implementation, we could make Orange County an esophageal cancer-free zone.”
A renowned digestive health expert, Dr. Chang outlines how emerging technologies, diagnostic tools, and multidisciplinary care models are reshaping how we detect and manage digestive diseases.
Why is early detection of esophageal cancer so important?
KC: Esophageal cancer continues to rise in incidence, largely due to ineffective screening methods and low public awareness. GERD, if left untreated, can lead to Barrett’s Esophagus (BE), a known precursor to esophageal cancer. Research shows that treating BE can reduce the risk of cancer by up to 90%.
Endoscopy is the gold standard for diagnosing these conditions but has limitations as a screening tool — many people at risk don’t get an endoscopy until symptoms like difficulty swallowing emerge, which is often too late.
Hoag is the first health system in the United States to offer a comprehensive, on-site screening program using a breakthrough non-invasive technology, EsoGuard®. Recommended for individuals with multiple risk factors — such as GERD, male sex, age, white ethnicity, obesity, smoking, family history of BE or esophageal cancer — EsoGuard is a DNA-based test that takes two minutes to administer without sedation. A positive test is 90% accurate and confirmed by endoscopy; a negative test has a 99% confidence rate confirming a healthy esophagus.
Combining risk-based screening, innovative tools like EsoGuard, and evidence-based care protocols, Hoag aims to prevent esophageal cancer before it starts.
How is technology being used to prevent or manage esophageal and digestive diseases?
KC: We live in the Information Age, but the quality of that information is highly variable. Hoag has invested significantly in developing a first-of-its-kind assessment platform to provide much-needed medical guidance for patients with all levels of GERD symptoms.
Hoag’s GERD Hub includes an interactive 20-question risk assessment tool, which covers lifestyle, symptoms, and family history. Using this information, the platform generates a personalized plan that is approved by our Digestive Health Institute clinical experts so patients can have peace of mind that they are receiving information from a trusted source.
By combining GERD Hub for early risk detection with EsoGuard for targeted screening, we can prevent esophageal cancer and improve health outcomes in our community and beyond.
What makes Hoag’s Digestive Health Institute unique?
KC: Hoag is a unique place where innovation is fueled by compassion. Our institute brings together nationally recognized physicians across digestive subspecialties who are committed to innovation, prevention, and cutting-edge care.
I have the privilege of leading this multidisciplinary institute of subspecialists across our Centers of Excellence: Heartburn and Foregut, Weight and Metabolic, IBD and Colon Health, Digestive Oncology, as well as our Liver and Motility programs. These teams include surgeons, gastroenterologists, hepatologists, advanced interventional endoscopists, radiologists, pathologists, advanced practice providers, nurses, psychologists, dieticians, and social workers who work collaboratively to improve people’s lives every day.
As Orange County’s top-ranked health system, Hoag is leading the “privademic” model — combining private innovation with academic-level expertise. Hoag’s Sun Family Campus in Irvine is undergoing a $1 billion expansion and will feature a new Cancer & Digestive Hospital Pavilion, the only one of its kind in Orange County. This facility will further augment our ability to bring the latest medical, interventional, and surgical break-through technologies to the region.
Our audacious goal of ending esophageal cancer in Orange County may be bold, but is achievable, and we’re well on our way.
