ASGE Masterclass: Barrett’s Esophagus, GERD and Esophageal Adenocarcinoma (On Demand) | February 2022-Screening and surveillance in Barrett's Esophagus

Video Transcription

Video Summary

In this video, Dr. Iyer discusses the importance of screening and surveillance in patients with Barrett's esophagus. He explains that patients with reflux and certain risk factors are at risk for developing Barrett's, which can progress to esophageal adenocarcinoma. Dr. Iyer emphasizes the need for early detection and intervention to prevent this progression. He explains that the incidence and mortality of esophageal adenocarcinoma have been increasing over the past few decades. He discusses the role of endoscopic screening and surveillance in detecting dysplasia or early cancer in Barrett's patients. He presents evidence that treating dysplasia or early cancer can reduce the risk of progression to esophageal adenocarcinoma. Dr. Iyer also explores the challenges of current screening methods, such as sedated endoscopy, and suggests the need for minimally invasive and cost-effective screening tools. He highlights two technologies: swallowed esophageal sampling devices combined with biomarkers, and exhaled volatile organic compounds. He explains how these technologies can improve access, participation, and cost-effectiveness of screening. Additionally, Dr. Iyer discusses the detection of dysplasia in patients with Barrett's using a brush-based technology called WATS, Wide Area Transepithelial Sampling. He explains that WATS can improve the sampling of Barrett's mucosa and increase the yield of dysplasia detection compared to traditional biopsies. Finally, he touches upon risk prediction and mentions the development of personalized prediction models using clinical and biomarker factors. He introduces the tissue cipher assay, a lab-developed test that uses a series of biomarkers and nuclear morphology to assess the risk of progression in Barrett's patients. Dr. Iyer highlights the advantages and limitations of this test and suggests potential improvements to increase sensitivity.

Keywords

Barrett's esophagus

esophageal adenocarcinoma

screening

surveillance

early detection

dysplasia

WATS