Barrett's esophagus: diagnostic approaches and surveillance.
In an effort to identify those patients at risk for developing esophageal adenocarcinoma, the American College of Gastroenterology recommends screening endoscopy in patients with chronic gastroesophageal reflux disease. Surveillance endoscopy is recommended every 3 years in those patients without dysplasia. For those patients with verified low-grade dysplasia, yearly surveillance endoscopy is recommended. In the case of high-grade dysplasia (HGD), either intensive endoscopic surveillance (focal HGD) or ablation/resection can be performed (multifocal HGD). Both observational and cost-effectiveness analyses suggest a potential benefit of endoscopic screening and surveillance, though these findings remain to be validated in controlled clinical trials. The development of new endoscopic imaging modalities may enhance the yield of biopsies obtained during screening and surveillance regimens.
Schuchert
Matthew J
MJ
Division of Thoracic and Foregut Surgery, Department of Surgery, University of Pittsburgh, School of Medicine, UPMC Health System, Pittsburgh, PA 15213, USA. schuchertmj@msx.upmc.edu
McGrath
Kevin
K
Buenaventura
Percival O
PO
D001471:Barrett Esophagus / Q000175:diagnosis* / Q000473:pathology; D003362:Cost-Benefit Analysis; D004848:Epithelium / Q000473:pathology; D004945:Esophagoscopy / Q000191:economics / Q000379:methods*; D006801:Humans; D007089:Image Enhancement; D011159:Population Surveillance; D018570:Risk Assessment; D041623:Tomography, Optical Coherence