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Diagnostic and Management Implications of Basic Science Advances in Barrett’s Esophagus

  • Esophagus (E Dellon, Section Editor)
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Opinion statement

Barrett’s esophagus (BE) is a well-established premalignant condition for esophageal adenocarcinoma (EAC), a cancer that has increased in the Western world by nearly sixfold over the past three decades and is associated with a dismal 5-year survival rate (<20 %) especially when detected at a symptomatic state. Given the dramatic rise in EAC incidence and poor outcomes, much attention has focused on screening and surveillance in BE with a goal of identifying curable lesions and improving outcomes in patients with EAC. The limitations of current screening and surveillance strategies provide the necessary impetus to improve diagnostic accuracy and risk stratification of patients with BE. Biomarkers have the potential to predict risk of progression to cancer, identify patients most likely to respond to endoscopic eradication therapies, and ultimately influence patient management and outcomes. The goal of identifying such a biomarker or panel of biomarkers ready for clinical application remains elusive. This review highlights the recent advances in the field of biomarkers. It is increasingly being recognized that a single biomarker is suboptimal in accurate clinical risk stratification of individuals at highest risk for progression to cancer and an ideal risk stratification tool should include a panel of biomarkers in conjunction with clinical and endoscopic factors. Finally, we review advances in our screening strategies with use of Cytosponge, transnasal endoscopy, and tethered capsule endomicroscopy and surveillance strategies with use of advanced imaging techniques. Feasibility of these novel technologies for large population screening and surveillance needs to be assessed in future trials.

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Conflict of Interest

Meghan Jankowski declares that she has no conflict of interest.

Sachin Wani is supported by the American Gastroenterological Association Takeda Research Scholar Award in GERD and Barrett’s esophagus and University of Colorado Department of Medicine Early Scholars Award. Dr. Wani has also received a grant from Covidien.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA

    Meghan Jankowski MD & Sachin Wani MD

  2. Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Center, Mail Stop F735 1635 Aurora Court, Rm 2.031, Aurora, CO, 80045, CO

    Sachin Wani MD

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  1. Meghan Jankowski MD
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  2. Sachin Wani MD
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Correspondence to Sachin Wani MD.

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This article is part of the Topical Collection on Esophagus

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Jankowski, M., Wani, S. Diagnostic and Management Implications of Basic Science Advances in Barrett’s Esophagus. Curr Treat Options Gastro 13, 16–29 (2015). https://doi.org/10.1007/s11938-014-0040-9

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