ESGE HEADLINE NEWS N°2

Screening and surveillance for Barrett’s esophagus

R Lambert

Synopsis

Many etiological factors are involved in the development of Barrett’s esophagus (BE). They include gastroesophageal reflux disease (GERD), with inflammatory stress leading to metaplastic transformation of the mucosa. Ethnic origins, male sex, obesity in adolescence, and smoking may also play a role.

BE is a precancerous condition, but the risk of cancer is lower than previously estimated, at approximately 0.5 cancers per 100 patient-years in Caucasian males. However, the prevalence of GERD is increasing both in the West and in Asia, and this may justify strategies for prevention and early detection of Barrett’s esophagus.

To prevent esophageal adenocarcinoma, systematic screening to detect Barrett’s esophagus should be carried out during all upper gastrointestinal endoscopy examinations, for whatever indication. When patients with BE are identified during endoscopic examinations that follow recommended quality control criteria, they should be included in surveillance strategies with follow-up intervals adjusted to the scale of the individual risk.

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References

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Prevention
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