AGA Clinical Practice Update on New Technology and Innovation for Surveillance and Screening in Barrett’s Esophagus: Expert Review

Diagnosis and Management of Barrett’s Esophagus

“…Well-established risk factors, listed in the guidelines of the American Gastroenterological Association (AGA) [ 13 ] for this condition include male sex [ 14 , 15 ], white race [ 15 ], history of smoking [ 16 , 17 , 18 ], chronic gastroesophageal reflux disease (GERD) [ 16 , 19 ], obesity [ 16 , 20 , 21 , 22 ] and family history of BE or EAC [ 23 , 24 ]. Similar risk factors have been published in the Asia-Pacific consensus on the management of GERD [ 25 ].…”

“…Despite the low absolute risk, the relative risk (RR) is high when compared to the general population. Due to this fact, most leading gastroenterology societies recommend an NDBE endoscopic surveillance every 3–5 years [ 13 , 51 , 52 ]. Regular surveillance surely leads to an earlier detection of dysplasia, although it is yet to be proven whether it is beneficial for the patient’s survival.…”

“…Asia-Pacific consensus on the management of GERD pointed out that the low prevalence rates in this population make screening for BE in the region unnecessary [ 25 ]. Guidelines of the American Gastroenterological Association (AGA) [ 13 ] suggest that screening may be considered for those with at least three well-established risk factors for BE and EAC, such as the following: being male, non-Hispanic white, age >50 years, having a history of smoking, chronic gastroesophageal reflux disease, obesity, or a family history of BE or esophageal adenocarcinoma. Importantly, in those guidelines, chronic gastroesophageal reflux disease (GERD) is not considered a mandatory requirement to screen for BE.…”

“…AGA recommends using high-definition white light endoscopy (HD-WLE) and virtual chromoendoscopy (VC) during screening and surveillance [ 13 ]. In patients with NDBE, surveillance ought to be performed every 3–5 years [ 13 ].…”

“…AGA recommends using high-definition white light endoscopy (HD-WLE) and virtual chromoendoscopy (VC) during screening and surveillance [ 13 ]. In patients with NDBE, surveillance ought to be performed every 3–5 years [ 13 ]. Guidelines of the American College of Gastroenterology (ACG) recommend basing the surveillance frequency on the length of BE segment ( Figure 1 ) [ 91 ].…”