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World J Gastroenterol. May 7, 2019; 25(17): 2045-2057
Published online May 7, 2019. doi: 10.3748/wjg.v25.i17.2045
Evolving screening and surveillance techniques for Barrett's esophagus
David Steele, Kondal Kyanam Kabir Baig, Shajan Peter
David Steele, Kondal Kyanam Kabir Baig, Shajan Peter, Basil Hirschowitz Endoscopic Centre of Endoscopic Excellence, Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, Birmingham, AL 35294, United Sates
Author contributions: Steele D was responsible for the literature review, analysis, interpretation and drafting of the article; Kyanam Kabir Baig K was responsible for additional design, critical revision of the article for important intellectual content; Peter S was responsible for conception and design, critical revision and final approval of article.
Conflict-of-interest statement: No potential conflicts of interest. No financial support.
Open-Access: 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/
Corresponding author: Shajan Peter, FASGE, MD, Associate Professor, Basil Hirschowitz Endoscopic Centre of Endoscopic Excellence, Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, 6th Floor Jefferson Tower, 625 19th Street South, Birmingham, AL 35249, United States. ssugandha@uabmc.edu
Telephone: +1-205-9346110
Received: January 21, 2019
Peer-review started: January 21, 2019
First decision: February 21, 2019
Revised: March 26, 2019
Accepted: April 10, 2019
Article in press: April 11, 2019
Published online: May 7, 2019
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.