Although endoscopic surveillance of patients with Barrett's esophagus has been widely implemented, its effectiveness is debateable.
Dr de Jonge's team from Washington, USA investigate the effectiveness of endoscopic surveillance of patience with Barrett's esophagus.
The recently reported low annual esophageal adenocarcinoma risk in population studies, and the failure to identify most Barrett's patients at risk of disease progression undermine the effectiveness of management.
In addition, the team note that the poor adherence to surveillance and biopsy protocols, and the significant risk of misclassification of dysplasia all tend to undermine the effectiveness of current management, in particular, endoscopic surveillance programs, to prevent or improve the outcomes of patients with esophageal adenocarcinoma.
|More accurate techniques are needed to run efficient surveillance programs |
The ongoing increase in incidence of Barrett's esophagus and consequent growth of the surveillance population, together with the associated discomfort and costs of endoscopic surveillance, demand improved techniques for accurately determining individual risk of esophageal adenocarcinoma.
More accurate techniques are needed to run efficient surveillance programs in the coming decades.
Dr de Jonge's team comments, "In this review, we will discuss the current knowledge on the epidemiology of Barrett's esophagus, and the challenging epidemiological dilemmas that need to be addressed when assessing the current screening and surveillance strategies."