Singh DM, Trindade AJ. Strategies to prevent Barrett’s esophagus associated esophageal adenocarcinoma. World J Gastroenterol 2025; 31(39): 108853 [DOI: 10.3748/wjg.v31.i39.108853]
Corresponding Author of This Article
Arvind J Trindade, MD, Professor, Rutgers University School of Medicine, Division of Gastroenterology, Robert Wood Johnson University Hospital, RWJBarnabas Health, 1 Robert Wood Johnson Place, MEB401b, New Brunswick, NJ 08901, United States. arvind.trindade@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Oct 21, 2025; 31(39): 108853 Published online Oct 21, 2025. doi: 10.3748/wjg.v31.i39.108853
Strategies to prevent Barrett’s esophagus associated esophageal adenocarcinoma
Dashmeet M Singh, Arvind J Trindade
Dashmeet M Singh, Arvind J Trindade, Rutgers University School of Medicine, Division of Gastroenterology, Robert Wood Johnson University Hospital, RWJBarnabas Health, New Brunswick, NJ 08901, United States
Author contributions: Singh DM and Trindade AJ contributed equally to this work. Trindade AJ and Singh DM conducted the literature review, did the analysis, interpretation of data and drafted the original manuscript. All authors prepared the draft and approved the submitted version.
Conflict-of-interest statement: Trindade AJ reports personal fees from Lucid Diagnostics, personal fees from Exact Science, outside the submitted work.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Arvind J Trindade, MD, Professor, Rutgers University School of Medicine, Division of Gastroenterology, Robert Wood Johnson University Hospital, RWJBarnabas Health, 1 Robert Wood Johnson Place, MEB401b, New Brunswick, NJ 08901, United States. arvind.trindade@gmail.com
Received: April 25, 2025 Revised: June 30, 2025 Accepted: September 12, 2025 Published online: October 21, 2025 Processing time: 180 Days and 6 Hours
Abstract
There has been a rise in the incidence of esophageal adenocarcinoma (EAC) over the past five decades in the United States, and it remains a highly lethal malignancy due to frequent late-stage diagnosis. Barrett’s esophagus (BE), a well-established precursor to EAC, presents a critical window for early intervention through screening, surveillance, and endoscopic eradication therapy. Despite gastrointestinal society guideline recommendations for screening, the majority of patients with BE or early EAC remain undiagnosed until symptoms of late-stage cancer emerge. This review outlines current challenges and evolving strategies in the United States in BE detection and management, including risk stratification models, non-endoscopic screening tools, high-quality endoscopic techniques, tissue-based biomarkers, and artificial intelligence-enhanced imaging. We highlight best practices for surveillance, emphasizing the importance of thorough inspection of high-risk anatomic zones and the integration of advanced imaging. Endoscopic eradication therapy, including endoscopic mucosal resection and ablation, achieves high rates of complete eradication when performed with meticulous technique, especially with comprehensive treatment of the gastroesophageal junction and gastric cardia. Long-term surveillance remains essential due to the risk of recurrence. As new technologies continue to emerge, integrating precision tools into routine practice will be key to improving outcomes and reducing EAC mortality.
Core Tip: The incidence of Barrett’s esophagus associated esophageal adenocarcinoma continues to rise. Several factors contribute to this problem, including a lack of recognition of high-risk patients, inconsistent screening mechanisms, and ineffective endoscopic evaluation and management of recognized disease. In this review, we provide a comprehensive and multifaceted overview of strategies to improve in all three domains to help prevent esophageal adenocarcinoma.
