Screening for Barrett’s Esophagus
N. T. Nguyen, J. O. Clarke, J. C. Lipham, K. J. Chang, F. Schnoll-Sussman, R. C.W. Bell, & P. J. Kahrilas
The AFS Textbook of Foregut Disease
Barrett’s esophagus (BE) is the only known precursor for esophageal adenocarcinoma, a lethal cancer when diagnosed after the onset of symptoms, with exponentially increasing incidence. It progresses to adenocarcinoma via the development of dysplasia. Progression to adenocarcinoma can be prevented by endoscopic eradication therapy. Hence, screening for BE is recommended so that those at risk for adenocarcinoma can be identified and placed under endoscopic surveillance to detect dysplasia, which can then be endoscopically treated. Early-stage adenocarcinoma can also be treated effectively endoscopically. Given that sedated endoscopy to diagnose BE is invasive and expensive, minimally invasive nonendoscopic techniques are being developed. These combine cytology samples of the esophagus with novel biomarkers. Nonendoscopic esophageal imaging technologies are also being developed. These technologies have the potential to reduce esophageal adenocarcinoma incidence and mortality. Developing tools to assess Barrett’s and adenocarcinoma risk and improve dysplasia detection on endoscopic evaluation is equally important to ensure success of this strategy.
Bapaye, J., Triadafilopoulos, G., & Iyer, P. G. (2023). Screening for Barrett’s Esophagus. The AFS Textbook of Foregut Disease, 147-159. https://doi.org/10.1007/978-3-031-19671-3_16