Why is it critical to be accurate in the diagnosis of Barretts esophagus?
Unfortunately, most cancers of the esophagus are detected too late to be treated effectively. By the time cancer-related symptoms of chest pain, weight loss, and progressive difficulty in swallowing (dysphagia) lead to the diagnosis, the cancer has already spread beyond the esophagus to other organs. Indeed, there is evidence that survival is markedly improved in cancers detected during the course of surveillance for dysplasia or cancer in Barrett’s esophagus as compared with survival in cancers detected after cancer symptoms prompted medical attention. Therefore, physicians want to make the diagnosis of Barrett’s in GERD patients and then begin surveillance for cancer in such patients. The problem, however, as mentioned previously, is that only 5% of all patients with adenocarcinomas of the esophagus or cardia have had an endoscopy to show that they have Barrett’s esophagus. Thus, the challenge is to identify those GERD patients who have Barrett’s by screening patients with chronic GE
