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Review
. 2022 Jun;38(3):161-167.
doi: 10.1159/000522015. Epub 2022 Feb 25.

Barrett's Oesophagus: Today's Mistake and Tomorrow's Wisdom in Screening and Prevention

W Keith Tan  1   2   3 , Massimiliano di Pietro  1   2
Affiliations
Review

Barrett's Oesophagus: Today's Mistake and Tomorrow's Wisdom in Screening and Prevention

W Keith Tan et al. Visc Med. 2022 Jun.

Abstract

Background: Oesophageal adenocarcinoma (OAC) is a lethal cancer with an overall 5-year survival of <20%. Given the presence of a pre-invasive disease stage, also known as Barrett's oesophagus (BO), and the availability of minimally invasive treatments for BO-related neoplasia, it is thought that early detection is the best strategy to improve patient outcomes. Clinical guidelines recommend endoscopic screening in patients with symptoms of acid reflux and additional risk factors. This strategy is flawed by the cost and invasiveness of endoscopy as well as by the fact that a significant proportion of OAC patients deny a history of reflux symptoms.

Summary: New research on the use of epidemiologic and clinical data has allowed the creation of risk-prediction algorithms to identify the population at risk. In addition, newer less-invasive devices such as transnasal endoscopy, Cytosponge, volumetric laser endomicroscopy, and volatile organic compounds are emerging as promising options to allow screening in the primary care setting. Finally, there is an opportunity to intervene at the pre-invasive stage with pharmacological strategies to reduce the risk burden.

Key messages: In this review, we provide a critical appraisal of the different screening approaches and chemopreventive strategies and a guide to readers on how to implement research evidence in clinical practice.

Keywords: Barrett's oesophagus; Endoscopy; Oesophageal adenocarcinoma; Prevention; Screening.

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Conflict of interest statement

The authors declare no conflicts of interest.

References

    1. Cancer research UK (CRUK) oesophageal cancer statistics. Available from: https://www.cancerresearchuk.org/health-professional/cancer-statistics/s....
    1. Ronkainen J, Aro P, Storskrubb T, Johansson SE, Lind T, Bolling–Sternevald E, et al. Prevalence of Barrett's esophagus in the general population: an endoscopic study. Gastroenterology. 2005;129((6)):1825–31. - PubMed
    1. Westhoff B, Brotze S, Weston A, McElhinney C, Cherian R, Mayo MS, et al. The frequency of Barrett's esophagus in high-risk patients with chronic GERD. Gastrointest Endosc. 2005 Feb;61((2)):226–31. - PubMed
    1. Hamade N, Weng G, Desai M, Chandrasekar VT, Dasari C, Kennedy K, et al. Significant decline in the prevalence of Barrett's esophagus among patients with gastroesophageal reflux disease. Dis Esophagus. 2021 May 22;34((5)):doaa13. - PubMed
    1. Desai TK, Krishnan K, Samala N, Singh J, Cluley J, Perla S, et al. The incidence of oesophageal adenocarcinoma in non-dysplastic Barrett's oesophagus: a meta-analysis. Gut. 2012;61((7)):970–6. - PubMed