Surveillance of Barrett's oesophagus is of little benefit

Barrett's oesophagus (metaplasia within the oesophagus) increases the risk of developing adenocarcinoma. However, the value of performing regular surveillance endoscopies to detect premalignant and early malignant changes remains uncertain. Macdonald et al (p 1252) reviewed the clinical outcome of patients having annual endoscopic surveillance over 10 years. They found that surveillance did not benefit patients. In four of the five patients who developed oesophageal carcinoma, the cancer was detected while investigating worsening symptoms not by surveillance endoscopy, and the fifth patient died postoperatively. The authors suggest that surveillance should be offered only to patients with additional risk factors such as oesophageal strictures or ulcers.

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Relevant Article

Final results from 10 year cohort of patients undergoing surveillance for Barrett's oesophagus: observational study

Christopher E Macdonald, Anthony C Wicks, and Raymond J Playford
BMJ 2000 321: 1252-1255. [Abstract] [Full Text] [PDF]