- The American Society for Gastroenterology Endoscopy (ASGE) has issued updated guidelines on screening and surveillance in Barrett's esophagus (BE).
Why this matters
- Recent advances have addressed limitations in previous screening and surveillance regimens.
- Surveillance should be performed on patients with nondysplastic BE (conditional).
- Not enough evidence exists to recommend screening for BE, but if screening is performed, it should include identification of individuals with a family history of esophageal adenocarcinoma or BE, or patients with GERD and ≥1 additional risk factor.
- Chromoendoscopy should be used with virtual chromoendoscopy and Seattle protocol biopsy sampling, as opposed to white-light endoscopy with Seattle protocol biopsy sampling (strong).
- White-light endoscopy with Seattle protocol biopsy sampling should be favored over confocal laser endomicroscopy (conditional).
- Endoscopic ultrasound should not be routinely used to differentiate mucosal and submucosal disease in patients with BE with high-grade dysplasia/intramucosal cancer or nodules (strong).
- When BE is known or suspected, wide-area transepithelial sampling with computer-assisted 3-dimensional analysis and Seattle protocol biopsy is recommended over white-light endoscopy and Seattle protocol biopsy sampling (conditional).
- There is insufficient evidence to recommend for or against the routine use of volumetric laser endomicroscopy in surveillance of patients with BE.