Surveillance in Barrett?s Esophagus: Challenges, Progress, and Possibilities

Endoscopic surveillance of Barrett's esophagus, aiming detect prevalent dysplasia and adenocarcinoma, followed by effective endoscopic treatment, is an integral part the esophageal adenocarcinoma prevention paradigm. However, several limitations, such as the subtle appear-ance of dysplasia, sampling error (inherent in current surveillance protocols), and noncompliance with sur-veillance recommendations, lead to missed dysplasia and neoplasia, reducing the effectiveness of surveillance currently practiced. Careful endoscopic assessment with high-resolution white-light endoscopy, dye-based electronic chromoendoscopy, and comprehensive sam-pling of the BE mucosa, remains the cornerstone endoscopic surveillance. Emerging innovations in this area span the gamut of more efficient sampling methods, advanced imaging tools, artificial intelligence, and lecular marker-powered approaches as adjuncts, identify prevalent and predict incident dysplasia adenocarcinoma. Development and implementation validated quality indicators will allow additional advancement of this critical field. These approaches will hopefully enable efficient and effective cancer prevention and treatment.

Automated summary

Endoscopic surveillance of Barrett's esophagus is crucial for detecting dysplasia and adenocarcinoma, but it has limitations such as subtle appearance of dysplasia and sampling errors. High-resolution white-light endoscopy, electronic chromoendoscopy, and comprehensive sampling are essential for surveillance. Emerging innovations including advanced imaging tools and molecular marker-powered approaches can improve the efficiency of surveillance. Validated quality indicators are needed for further advancement in this field to achieve efficient and effective cancer prevention and treatment.