Surveillance Intervals for Barrett’s Esophagus Need to be Changed-Surveillance Intervals are Too Long and Should be Shortened

Abstract

Barrett’s esophagus (BE) surveillance remains fraught with controversy and variation in real-world clinical practices. The application of current guideline-recommended surveillance intervals has not significantly impacted the incidence of esophageal adenocarcinoma (EAC), nor survival. One fifth of patients with EAC present in the first year after a negative upper endoscopy. Additionally, the progression from BE to EAC may occur in a non-linear fashion and more rapidly than previously believed due sudden genomic catastrophes requiring intensified surveillance. Emerging data supports the role of molecular markers for risk stratification and a more patient-centered surveillance approach rather than less vigorous universal surveillance intervals.