Evolving screening and surveillance techniques for Barrett's esophagus

Abstract

Barrett’s esophagus (BE) is a change in the esophageal lining and is known to be the major precursor lesion for most cases of esophageal adenocarcinoma (EAC). Despite an understanding of its association with BE for many years and the falling incidence rates of squamous cell carcinoma of the esophagus, the incidence for EAC continues to rise exponentially. In association with this rising incidence, if the delay in diagnosis of EAC occurs after the onset of symptoms, then the mortality at 5 years is greater than 80%. Appropriate diagnosis and surveillance strategies are therefore vital for BE. Multiple novel optical technologies and other advanced approaches are being utilized to assist in making screening and surveillance more cost effective. We review the current guidelines and evolving techniques that are currently being evaluated.

Keywords: Barrett’s esophagus; Screening; Surveillance; New techniques; Endoscopy; Imaging; Radiofrequency ablation; Narrow band imaging

Core tip: Appropriate screening and diagnosis of Barrett’s esophagus and dysplasia and thereby cancer prevention is challenging. Newer imaging modalities aid and complement the role of traditional endoscopy with biopsy. Research in this area is promising and primarily focused on improved optical technology and advanced sampling techniques.