Final results from 10 year cohort of patients undergoing surveillance for Barrett's oesophagus: observational study.
OBJECTIVE
To review the benefit of an endoscopic surveillance programme for patients with Barrett's oesophagus.


METHODS
Observational study.


METHODS
University teaching hospital.


METHODS
409 patients in whom Barrett's oesophagus was identified during 1984-94; 143 were entered into the annual surveillance programme.


METHODS
Development of dysplasia and cancer and mortality.


RESULTS
The average period of surveillance was 4.4 years; 55 patients were reassessed in 1994 but only eight remained in the programme in 1999, withdrawal being due to death (not from carcinoma of the oesophagus), illness, or frailty. Five of the patients who entered surveillance developed carcinoma of the oesophagus. Only one cancer was identified as a result of a surveillance endoscopy, the others being detected during endoscopy to investigate altered symptoms. Of the 266 patients who were not suitable for surveillance, one died from oesophageal cancer and 103 from other causes. Surveillance has resulted in 745 endoscopies and about 3000 biopsy specimens.


CONCLUSIONS
The current surveillance strategy has limited value, and it may be appropriate to restrict surveillance to patients with additional risk factors such as stricture, ulcer, or long segment (>80 mm) Barrett's oesophagus.
Macdonald
C E
CE
Leicester General Hospital NHS Trust, Leicester LE5 4PW, UK.
Wicks
A C
AC
Playford
R J
RJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D001471:Barrett Esophagus / Q000150:complications / Q000453:epidemiology*; D015331:Cohort Studies; D004739:England / Q000453:epidemiology; D004938:Esophageal Neoplasms / Q000150:complications / Q000453:epidemiology*; D004945:Esophagoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000453:epidemiology; D011379:Prognosis; D018571:Sentinel Surveillance; D016526:Workload