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Screening for Barrett oesophagus — a call for collaboration between gastroenterology and primary care

Nature Reviews Gastroenterology & Hepatology volume 20, pages 342–343 (2023)Cite this article

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Barrett oesophagus is not detected before its progression to oesophageal adenocarcinoma in over one-half of patients, and improvements in screening for Barrett oesophagus in primary care could substantially reduce mortality associated with this cancer. Advances in screening technology will help, but collaboration of gastroenterologists with primary care providers is essential.

The incidence of oesophageal adenocarcinoma is rising in the USA1. Barrett oesophagus is the main risk factor for oesophageal adenocarcinoma but is not identified until after it has progressed to cancer in 57% of patients with newly diagnosed oesophageal adenocarcinoma2. Consequently, we are missing substantial opportunities for cancer prevention. Barrett oesophagus progresses sequentially from nondysplastic disease, to Barrett oesophagus with dysplasia, then to oesophageal adenocarcinoma. This progression affords an opportunity to screen for Barrett oesophagus and intervene while it is still in the dysplastic phase, before the development of invasive oesophageal adenocarcinoma. Retrospective studies have shown that screening and surveillance programmes reduce mortality associated with oesophageal adenocarcinoma and overall mortality3 and, on this basis, screening is endorsed in guidelines from gastroenterology societies1,4.

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Fig. 1: Proposed approach for screening for Barrett oesophagus in primary care.

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Authors and Affiliations

  1. Zucker School of Medicine at Hofstra/Northwell, Long Island Jewish Medical Center, New Hyde Park, NY, USA

    Arvind J. Trindade

  2. Institute of Health Innovations and Outcomes Research, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA

    Arvind J. Trindade

  3. Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, Chapel Hill, NC, USA

    Nicholas J. Shaheen

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  1. Arvind J. Trindade
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Correspondence to Arvind J. Trindade.

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Competing interests

A.J.T. receives research support from Lucid Diagnostics and is a consultant for Boston Scientific, Exact Science, Lucid Diagnostic and Pentax Medical. N.J.S. receives research funding from Interpace Diagnostics, Lucid Diagnostics, Medtronic, Pentax Medical and Steris, and is a consultant for Boston Scientific, Cernostics, CDx Diagnostics, Cook Medical, Exact Sciences and Phathom.

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Trindade, A.J., Shaheen, N.J. Screening for Barrett oesophagus — a call for collaboration between gastroenterology and primary care. Nat Rev Gastroenterol Hepatol 20, 342–343 (2023). https://doi.org/10.1038/s41575-023-00773-4

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