Screening for Barrett's Oesophagus: Are We Ready for it?

Area of Science:

• Gastroenterology
• Oncology
• Medical Technology

Background:

• Barrett's oesophagus (BO) screening is currently suboptimal, leading to missed diagnoses.
• Endoscopic screening is invasive and costly, limiting its use for mass screening.
• There is a lack of consensus on appropriate screening populations for BO.

Purpose of the Study:

• To review recent technological advancements for improving BO detection.
• To identify strategies for enhancing current BO screening practices.
• To address the challenge of missed BO cases in current screening approaches.

Main Methods:

• Literature review of technological advancements in BO detection.
• Analysis of risk prediction algorithms for pre-screening enrichment.
• Evaluation of minimally invasive methods like trans-nasal endoscopy, oesophageal capsule endoscopy, and Cytosponge with biomarker analysis.

Main Results:

• Risk prediction algorithms show modest performance and require further validation.
• Less invasive methods, including Cytosponge, demonstrate promise for BO detection with clinical trial evidence.
• Endoscopy remains cost-effective for high-risk populations, but consensus on screening criteria is lacking.

Conclusions:

• A three-tier precision cancer program utilizing risk prediction and non-endoscopic cell collection can improve BO detection rates.
• Minimally invasive techniques offer a promising alternative or adjunct to traditional endoscopy for BO screening.
• Integrating advanced technologies into screening strategies is crucial for better outcomes in BO management.