title: Screening for Barrett's Esophagus.
abstract: The large increase in the incidence of esophageal adenocarcinoma in the West during the past 30 years has stimulated interest in screening for Barrett's esophagus (BE), a precursor to esophageal cancer. Effective endoscopic treatments for dysplasia and intramucosal cancer, coupled with screening programs to detect BE, could help reverse the increase in the incidence of esophageal cancer. However, there are no accurate, cost-effective, minimally invasive techniques available to screen for BE, reducing the enthusiasm of gastroenterologists. Over the past 5 years, there has been significant progress in the development of screening technologies. We review existing and developing technologies, new minimally invasive imaging techniques, nonendoscopic devices for cell collection, and biomarkers that can be measured in blood or stool samples. We discuss the status of these approaches, data from clinical studies of their effects, and their anticipated strengths and weaknesses in screening. The area is rapidly evolving, and new tools will soon be ready for prime time.
authors.affiliation: MRC Cancer Unit, University of Cambridge, Cambridge, England.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: di Pietro
authors.affiliation: Barrett's Esophagus Unit, Mayo Clinic, Rochester, Minnesota.
authors.forename: Daniel
authors.initials: D
authors.lastname: Chan
authors.affiliation: MRC Cancer Unit, University of Cambridge, Cambridge, England. Electronic address: rcf29@mrc-cu.cam.ac.uk.
authors.forename: Rebecca C
authors.initials: RC
authors.lastname: Fitzgerald
authors.affiliation: Barrett's Esophagus Unit, Mayo Clinic, Rochester, Minnesota. Electronic address: wang.kenneth@mayo.edu.
authors.forename: Kenneth K
authors.initials: KK
authors.lastname: Wang
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D001471:Barrett Esophagus / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D015415:Biomarkers / Q000032:analysis; D001706:Biopsy; D053704:Capsule Endoscopy; D004867:Equipment Design; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D020701:Esophagoscopes; D004945:Esophagoscopy / Q000295:instrumentation; D006801:Humans; D008403:Mass Screening / Q000295:instrumentation / Q000379:methods; D011230:Precancerous Conditions / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D015415:Biomarkers
keywords: Biomarkers; Biophotonics; Cytology; Endoscopy; FISH