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


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Authors
Fitzgerald, Rebecca C 
Abstract

PURPOSE OF REVIEW: The targeted approach adopted for Barrett's oesophagus (BO) screening is sub-optimal considering the large proportion of BO cases that are currently missed. We reviewed the literature highlighting recent technological advancements in efforts to counteract this challenge. We also provided insights into strategies that can improve the outcomes from current BO screening practises. RECENT FINDINGS: The standard method for BO detection, endoscopy, is invasive and expensive and therefore inappropriate for mass screening. On the other hand, endoscopy is more cost-effective for screening a high-risk population. A consensus has however not been reached on who should be screened. Risk prediction algorithms have been tested as an enrichment pre-screening tool reporting modest AUC's but require more prospective evaluation studies. Less invasive endoscopy methods like trans-nasal endoscopy, oesophageal capsule endsocopy and non-endoscopic cell collection devices like the Cytosponge coupled with biomarker analysis have shown promise in BO detection with randomised clinical trial evidence. SUMMARY: A three-tier precision cancer programme whereby risk prediction algorithms and non-endoscopic minimally invasive cell collection devices are used to triage test a wider pool of individuals may improve the detection rate of current screening practises with minimal cost implications.

Description
Keywords
Barrett’s oeosphagus, Cytopsonge, Early detection of cancer, Endoscopy, Oesophageal adenocarcinoma, Screening
Journal Title
Curr Treat Options Gastroenterol
Conference Name
Journal ISSN
1092-8472
1534-309X
Volume Title
19
Publisher
Springer Science and Business Media LLC
Sponsorship
MRC (unknown)
MRC (MR/W014122/1)