Update on Barrett's screening

Tom Vaughan

Feb 1, 2024 — 1 min read

While not breaking new ground, this manuscript from Mayo Clinic nicely reviews state of the art approaches to screening (and surveillance) for Barrett's esophagus and esophageal adenocarcinoma. These newer techniques including: three different swallowable cell sampling devices combined with biomarkers (now approved in society guidelines), capsule-based imaging, and analysis of molecular biomarkers from peripheral blood samples (e.g., circulating tumor DNA, circulating mRNA.)

Advances in Screening for Barrett Esophagus and Esophageal Adenocarcinoma.

Mayo Clin Proc. 2024 Jan 24:S0025-6196(23)00348-8. doi: 10.1016/j.mayocp.2023.07.014. Epub ahead of print. PMID: 38276943.

Vantanasiri K, Kamboj AK, Kisiel JB, Iyer PG.

Abstract

Esophageal adenocarcinoma (EAC), the primary form of esophageal cancer in the United States, is a lethal cancer with exponentially increasing incidence. Screening for Barrett esophagus (BE), the only known precursor to EAC, followed by endoscopic surveillance to detect dysplasia and early-stage EAC and subsequent endoscopic treatment (to prevent progression of dysplasia to EAC and to treat early-stage EAC effectively) is recommended by several society guidelines. Sedated endoscopy (the primary current tool for BE screening) is both invasive and expensive, limiting its widespread use. In this review, we aim to provide a comprehensive review of recent innovations in the nonendoscopic detection of BE and EAC. These include swallowable cell sampling devices combined with protein and epigenetic biomarkers (which are now guideline endorsed as alternatives to sedated endoscopy), tethered capsule endomicroscopy, emerging peripheral blood-sampled molecular biomarkers, and exhaled volatile organic compounds. We also summarize progress and challenges in assessing BE and EAC risk, which is an important complementary component of the process for the clinical implementation of these innovative nonendoscopic tools, and propose a new paradigm for the strategy to reduce EAC incidence and mortality.

Neoplastic progression in young Barrett's patients

Esophageal adenocarcinoma is quite rare among persons younger than 40 years, but the consequences of the disease, including years of life lost, can be devastating. Due to its rarity there has been little research on how risk factors in young persons (e.g., Barrett's esophagus (BE), obesity, GERD,

Diagnosis and management of GERD

While most adults occasionally experience symptoms of gastroesophageal reflux, such as heartburn and regurgitation, approximately 20% (30 million people in the U.S.) experience these symptoms more frequently, ranging from once a week to multiple times a day. (1) Complications associated with GERD can include esophageal strictures, ulcers, and even

Ethics of screening based on race/ethnicity

This article explores some of the ethical implications of using race and ethnicity for cancer screening, using esophageal adenocarcinoma and gastric cancer as examples. It highlights the disparities in cancer incidence and mortality among different racial and ethnic groups and examines the potential benefits and drawbacks of screening based (in

Tension between risk-based and patient-centered esophageal cancer screening

This interesting and thoughtful paper by Dr. Elspeth Davies at the University of Cambridge investigates the use of the capsule sponge test for screening Barrett's esophagus (BE) in a mobile clinic in England, highlighting the challenges in balancing patient-centered and risk-centered medical management. Through ethnographic fieldwork, the study