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

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; Endoscopy; Imaging; Narrow band imaging; New techniques; Radiofrequency ablation; Screening; Surveillance.

Conflict of interest statement

Conflict-of-interest statement: No potential conflicts of interest. No financial support.

Figures

Figure 1
Figure 1
Barrett’s esophagus segment under while light high definition endoscopy.
Figure 2
Figure 2
Barrett’s esophagus using narrow band imaging.
Figure 3
Figure 3
Barrett’s esophagus using zoom magnification endoscopy (near focus).
Figure 4
Figure 4
Confocal endomicroscopy imaging. A: Barrett’s esophagus with intestinal metaplasia; B: Barrett’s esophagus with high grade dysplasia; C: Esophageal adenocarcinoma.

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