Review
Copyright ©The Author(s) 2015.
World J Gastroenterol. Jun 7, 2015; 21(21): 6479-6490
Published online Jun 7, 2015. doi: 10.3748/wjg.v21.i21.6479
Table 1 Comparison of societal guidelines for screening and surveillance in Barrett’s esophagus
ScreeningSurveillance NDBESurveillance LGDSurveillance HGD
AGA[104]Screening for patients with multiple risk factorsRecommend surveillanceLow-grade dysplasia: 6-12 moHigh-grade dysplasia in the absence of eradication therapy: 3 mo
Age 50 yr or olderNo dysplasia:
Male sexthree to five years
White race
Chronic GERD
Hiatal hernia
Elevated body mass index
Intra-abdominal distribution of body fat
Screening in the general population is not recommended
BSG[48]Endoscopic screening can be considered in patients with chronic GERD symptoms and multiple risk factors (at least three of age 50 yr or older, white race, male sex, obesity)Patients with Barrett’s oesophagus shorter than 3 cm, with IM, should receive endoscopic surveillance every 3-5 yrHigh resolution endoscopy every 6 moNot recommended
The threshold of multiple risk factors should be lowered in the presence of family history including at least one first-degree relative with Barrett’s or OACPatients with segments of 3 cm or longer should receive surveillance every 2-3 yrFor HGD and Barrett’s-related adenocarcinoma confined to the mucosa, endoscopic therapy is preferred over esophagectomy or endoscopic surveillance
ASGE[33]Endoscopic screening for BE can beConsider no surveillanceConfirm with expert GI pathologistConfirm with expert GI pathologist
considered in select patients with multiple risk factors for BE and EAC, but patients should be informed that there is insufficient evidence to affirm that this practice prevents cancer or prolongs lifeIf surveillance is elected, perform EGD every 3 to 5 years with 4-quadrant biopsies every 2 cmRepeat EGD in 6 mo to confirm LGDConsider surveillance EGD every 3 mo in select patients, 4-quadrant biopsies every 1 cm
Consider endoscopic ablation in select casesSurveillance EGD every year, 4-quadrant biopsies every 1 to 2 cmConsider endoscopic resection or RFA ablation
Consider endoscopic resection or ablationConsider EUS for local staging and lymphadenopathy
Consider surgical consultation
ACP[34]Upper endoscopy may be indicated among men older than 50 yr with chronic GERD symptoms (symptoms for more than 5 yr) and additional risk factors (nocturnal reflux symptoms, hiatal hernia, elevated body mass index, tobacco use, and intra-abdominal distribution of fat) to detect esophageal adenocarcinoma and beFor surveillance evaluation in men and women with a history of be. In men and women with be and no dysplasia, surveillance examinations should occur at intervals no more frequently than 3 to 5 yr. More frequent intervals are indicated in patients with Barrett esophagus and dysplasia