Risk factors and populations at risk: selection of patients for screening for Barrett's oesophagus

Best Pract Res Clin Gastroenterol. 2015 Feb;29(1):41-50. doi: 10.1016/j.bpg.2014.11.009. Epub 2014 Dec 3.

Abstract

Screening for Barrett's oesophagus is an attractive notion due to the rising incidence of oesophageal adenocarcinoma, the relative ease of acquiring tissue from the oesophagus, and the availability of endoscopic therapy for early neoplastic lesions. If screening is recommended, the question remains: which patients should be screened? Endoscopy is frequently performed in patients with symptoms of gastro-oesophageal reflux disease, but the vast majority of patients diagnosed with oesophageal adenocarcinoma have never undergone a prior endoscopy. The efficiency of screening needs to be improved. A number of tools for predicting the presence of Barrett's oesophagus or future risk of developing oesophageal adenocarcinoma are available. More research is needed to validate these tools and to identify the thresholds at which screening should be offered.

Keywords: Barrett's oesophagus; Mass screening; Oesophageal neoplasms; Risk assessment.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adenocarcinoma / etiology
  • Adenocarcinoma / prevention & control*
  • Barrett Esophagus / diagnosis*
  • Early Detection of Cancer / methods*
  • Esophageal Neoplasms / etiology
  • Esophageal Neoplasms / prevention & control*
  • Esophagoscopy
  • Gastroesophageal Reflux / complications
  • Gastroesophageal Reflux / etiology
  • Humans
  • Patient Selection
  • Precancerous Conditions / diagnosis*
  • Risk Factors

Supplementary concepts

  • Adenocarcinoma Of Esophagus