Published online Apr 15, 2021. doi: 10.4251/wjgo.v13.i4.279
Peer-review started: November 8, 2020
First decision: December 17, 2020
Revised: December 31, 2020
Accepted: March 10, 2021
Article in press: March 10, 2021
Published online: April 15, 2021
Barrett’s esophagus (BE), a premalignant condition, is associated with increased risk of esophageal adenocarcinoma. However, major societies provide differing guidance on management of BE, making standardization challenging.
The Asian Barrett’s Consortium was founded in 2008 to develop strategies in tackling challenges faced in the management of BE in the Asia. The group previously reported that there was substantial variability in the published prevalence of BE in Asia, noting that these studies used different methodologies, enrolled populations, endoscopic practices and histopathological criteria. To further our efforts to improve our management of BE, we wanted to understand the varying management practices of endoscopists from various countries in Asia.
The study aimed to evaluate the preferred diagnosis and management practices of Asian endoscopists on BE. The findings will shape our future efforts to standardize the management approach of this condition.
An online survey comprising 11 questions, was distributed to gastrointestinal endoscopists from countries across Asia from July 2018 to July 2019. The survey questions were categorized to “preferred diagnosis and surveillance practice” and “preferred management approach”.
The study found that 42.0% of all endoscopists incorrectly used the squamo-columnar junction to identify the esophagogastric junction. Prague C and M criteria was seldomly used by endoscopists, and adherence to Seattle protocol was poor with only 6.3% always performing it. There were also differences in diagnosis and management of BE when comparing endoscopists within Japan and outside Japan.
Diagnosis and management of BE varied within Asia, with stark contrast between Japan and outside Japan. Lack of standardization, education and research are possible reasons to account for such differences.
Further research is required to identify reasons for non-adherence to certain protocols in the management of BE, and how we could attempt to standardize diagnosis and management of BE.