Non-endoscopic screening for Barrett’s oesophagus

Barrett’s oesophagus is characterised by the development of columnar line oesophageal mucosa and is thought to be a premalignant condition that increases the risk of adenocarcinoma of the oesophagus 30-40-fold. Adenocarcinoma of the oesophagus has a poor five year survival (0-13%). The incidence has increased from 7.6 to 12.8 per 100 000 men and 4.2 to 5.7 per 100 000 women over the past three decades in England and Wales,1 and from 0.7 to 3.2 per 100 000 in the United States.2 Cohort studies suggest that survival is longer in people with adenocarcinoma detected by surveillance than in those presenting with symptoms, and surveillance is recommended by all major gastroenterology societies, although evidence from randomised controlled trials to support this practice is lacking.3 In the linked study (doi:10.1136/bmj.c4372), Kadri and colleagues assessed whether non-endoscopic screening for Barrett’s oesophagus, using an ingestible oesophageal sampling device (Cytosponge) coupled with immunocytochemisty for trefoil factor 3, was accurate and acceptable to patients. …