Published online Dec 21, 2016. doi: 10.3748/wjg.v22.i47.10316
Peer-review started: September 20, 2016
First decision: October 10, 2016
Revised: October 30, 2016
Accepted: December 2, 2016
Article in press: December 2, 2016
Published online: December 21, 2016
Oesophageal cancer affects more than 450000 people worldwide and despite continued medical advancements the incidence of oesophageal cancer is increasing. Oesophageal cancer has a 5 year survival of 15%-25% and now globally attempts are made to more aggressively diagnose and treat Barrett’s oesophagus the known precursor to invasive disease. Currently diagnosis the of Barrett’s oesophagus is predominantly made after endoscopic visualisation and histopathological confirmation. Minimally invasive techniques are being developed to improve the viability of screening programs. The management of Barrett’s oesophagus can vary greatly dependent on the presence and severity of dysplasia. There is no consensus between the major international medical societies to determine and agreed surveillance and intervention pathway. In this review we analysed the current literature to demonstrate the evolving management of metaplasia and dysplasia in Barrett’s epithelium.
Core tip: Barrett's esophagus is a premalignant condition. Its malignant sequela, esophagogastric junctional adenocarcinoma, has a mortality rate of over 85%. The risk of developing esophageal adenocarcinoma in people who have Barrett's esophagus has been estimated to be 6-8 per 1000 person-years. Early identification of Barrett’s and adjusted management is very important to decrease oesophageal cancer related deaths worldwide.