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Endoscopic surveillance or ablation for Barrett's esophagus?
1Division of Gastroenterology, Department of Medicine, University of Washington School of Medicine, Seattle, WA 98195, USA.
Translational Gastroenterology and Hepatology
|February 1, 2019
Summary
Rising esophageal adenocarcinoma (EAC) rates necessitate early detection of Barrett's esophagus (BE). This review examines surveillance strategies and economic data to optimize management of BE patients, aiming to reduce EAC mortality.
Area of Science:
- Gastroenterology and Oncology
- Clinical Medicine
- Health Economics
Background:
- Esophageal adenocarcinoma (EAC) incidence is increasing globally.
- Barrett's esophagus (BE) is the primary precursor to EAC.
- High EAC mortality rates underscore the need for effective screening and surveillance.
Purpose of the Study:
- To review evidence supporting surveillance for BE to reduce EAC mortality.
- To integrate economic analyses into BE management strategies.
- To determine optimal management for patients with varying degrees of BE dysplasia.
Main Methods:
- Systematic review of studies on BE surveillance and EAC mortality reduction.
- Analysis of economic data related to BE management.
- Evaluation of endoscopic eradication therapy effectiveness.
Main Results:
- Evidence supports BE surveillance in reducing EAC mortality.
- Optimal management strategies vary based on dysplasia grade (high-grade, low-grade, none).
- Economic analyses are crucial for guiding resource allocation in BE care.
Conclusions:
- Surveillance for Barrett's esophagus is vital for decreasing esophageal adenocarcinoma mortality.
- Personalized management plans considering dysplasia grade and economic factors are essential.
- Further research may refine endoscopic eradication therapy indications.