title: Population screening for barrett esophagus: a prospective randomized pilot study.
abstract: OBJECTIVE
  To assess the feasibility of unsedated transnasal endoscopy (uTNE) and video capsule endoscopy (VCE) as alternatives to sedated endoscopy (sEGD) as screening tools for Barrett esophagus (BE) and to obtain preliminary estimates of participation rates for sEGD, uTNE, and VCE when used for community BE screening in a population cohort.
  
  
  METHODS
  From February 1, 2009, to May 31, 2010, patients from Olmsted County, Minnesota, who were older than 50 years and had no history of known BE were randomized (stratified by age, sex, reflux symptoms noted in a validated questionnaire) into 3 groups for esophageal evaluation with sEGD, uTNE, or VCE. Participation rates and safety profiles were estimated.
  
  
  RESULTS
  We contacted 127 patients to recruit 20 for each procedure arm (60 total). The probability of participation was 38% (95% confidence interval [CI], 26%-51%) for sEGD, 50% (95% CI, 35%-65%) for uTNE, and 59% (95% CI, 42%-74%) for VCE. Both uTNE and VCE were well tolerated without adverse effects. BE was identified in 3 patients and esophagitis in 8.
  
  
  CONCLUSIONS
  Unsedated techniques may be acceptable, feasible, and safe alternatives to sEGD to screen for BE in the community.
  
  
  BACKGROUND
  clinicaltrials.gov identifier: NCT00943280.
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, USA. prasad.ganapathy@mayo.edu
authors.forename: Joseph Y
authors.initials: JY
authors.lastname: Chang
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Talley
authors.forename: G Richard
authors.initials: GR
authors.lastname: Locke
authors.forename: David A
authors.initials: DA
authors.lastname: Katzka
authors.forename: Cathy D
authors.initials: CD
authors.lastname: Schleck
authors.forename: Alan R
authors.initials: AR
authors.lastname: Zinsmeister
authors.forename: Kelly T
authors.initials: KT
authors.lastname: Dunagan
authors.forename: Tsung-Teh
authors.initials: TT
authors.lastname: Wu
authors.forename: Kenneth K
authors.initials: KK
authors.lastname: Wang
authors.forename: Ganapathy A
authors.initials: GA
authors.lastname: Prasad
mesh_terms: D001471:Barrett Esophagus / Q000175:diagnosis* / Q000453:epidemiology; D053704:Capsule Endoscopy / Q000379:methods*; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D010865:Pilot Projects; D011446:Prospective Studies; D015203:Reproducibility of Results