Screening for Barrett's esophagus and esophageal adenocarcinoma: recent advances and next steps

The incidence of esophageal adenocarcinoma (EAC) has continued to increase, with a poor 5-year survival rate of ~20%. Barrett's esophagus is the only recognized precursor to EAC, so public health strategies focus on identifying and screening high-risk populations. Currently, the standard screening method is sedated esophagogastroduodenoscopy. However, this approach has challenges, including its invasive nature, need for sedation, higher cost, procedure-related risks, sampling error, and poor suitability for population-wide screening. As a result, alternative screening techniques such as transnasal endoscopy and less invasive options including non-endoscopic cell collection devices with biomarker assays have been explored. In this review, we summarize current approaches for identifying at-risk populations and screening methods and provide insights into technologies that could complement screening strategies in the future.